Proving I´m sane – a psychology lecture through the eyes of a former mental health patient, part IV

I guess at some point I´m going to have to write this entry, so I might as well do it now. It will mainly deal with a comment made by the latest professor to hold Dr. Bla´s lecture. I will call him Dr. Curl. So, Dr. Curl talked about personality disorders, and the comment, of course, referred to Narcissistic Personality Disorder. Before I can go into that, I will have to explain why I even attend psychology lectures.

I made three attempts at psychotherapy in my life, two of them being slightly analytically oriented talk therapies. The last attempt, the one with Dr. Stoneface, lasted for about two years before I quit. Quitting took me about one of those two years. I had felt the entire time that he was not being open with me, that he was trying to manipulate me, that he was following some kind of treatment plan or strategy which I was not supposed to know about. Not in the sense of a political or religious agenda. But everything he said was said for the effect it should have on me. I always wondered: “So how is this statement supposed to make me feel?” I felt like he was making secret assumptions about me, weighing his words for the potential effect, and then saying whatever would steer me into the direction he wanted to steer me into. It was like talking to someone who never gives his honest opinion on anything, who is never genuine – and being unable to prove it.

I called Dr. Stoneface out on this so many times. I told him he was toying with me, I told him he had made (potentially unfavorable) assumptions about me without giving me a chance to give my view, and I demanded that he finally told me my diagnosis. He refused. He called me “abnormally distrustful”, conveniently assuming that I was equally distrustful towards everybody else. I wasn´t, but he claimed so in such a convincing manner that I did indeed become abnormally distrustful towards a person other than him: myself.  I told him these were all just tricks to keep me in therapy, and he asked me why he would want to do that. He told me that I was free to leave, and in the same instant he told me I was not ready. When I told him he wasn´t being genuine, he denied it, leaving me to wonder if I should trust my own perception or if, maybe, my perception was distorted by the mysterious disorder I had. How could I have known, given that I didn´t know what my disorder was? Under such circumstances, becoming able to leave was a real victory.

Even though I had finally physically left therapy, Dr. Stoneface stayed with me. I could never stop wondering if I was really just being paranoid, abnormally distrustful, if my perception was distorted. I hoped, though, that if they weren´t going to tell a patient the truth, maybe they would at least be honest with their students. And so I decided to sneak into these two psychology lectures. As an undercover agent, so to say. And last Thursday, the miracle happened. One of them slipped up and told the truth.

It might sound like my life is some kind of weird movie, but on this precise day I had actually wondered if I should really go to the lecture. I wanted to, I was interested in what they´d say about personality disorders, but I was also tired and down. Lately I just don´t manage to get anything done. Therefore, I was at least 15 minutes late for the lecture. I took a seat and listened to Dr. Curl introducing all Cluster A and Cluster B personality disorders before the ran out of time. The last thing he talked about was NPD.  He explained that it is one of the most difficult disorders to treat, because narcissists don´t respond well to criticism or perceived criticism. And then he said  the crucial sentence: “Often you cannot even tell patients that they have Narcissistic Personality Disorder. They´d see that as a slight and they might leave therapy.”

It´s not like the room was shaken by an earthquake. I cannot even claim I was surprised or particularly shocked. It was precisely what I had always suspected, after all.  I guess I was the only one to whom this remark meant anything at all. The other students were already busy leaving. There was no whispering creeping through the ranks, no silent uproar. Nobody apart from me found it remarkable, leave alone outrageous, that it appears to be common practice to treat patients against disorders they have neither been informed of, nor given consent to be treated against. And why, after all? The patient is the “other”, after all, that weird, not-quite-as-human-as-us entity. He is not as clever as us, he won´t notice when we manipulate and deceive him. He is not psychologically enlightened, so we cannot treat him as a mature, equal human being, can we?

For a few moments I felt tempted to raise my hand and confront Dr. Curl about the issue of informed consent in front of everybody. But what for, really? I knew I was a minority of one, after all. I would draw a whole room full of negative  attention to myself, like “oh god, one of those naggers who always have to bitch about something! What´s next, questioning the whole concept of personality disorders because it´s insulting? If you knew how horrible such patients are, you´d understand why we treat them that way!”

What I decided to do, however, was address Dr. Curl personally and make absolutely sure I had gotten right what he said. Dr. Curl had explained that typically people with NPD will present for therapy with depression. What I was going to ask him was if therapists only treated those patients for depression, even if they suspected a personality disorder, or if they also treated them against NPD. If the first was the case, fair enough. If it was the latter, though, then I finally had a proof that my perception of Dr. Stoneface had been right. And I´d also know that Dr. Stoneface wasn´t an unfortunate exception, but the rule.

So I went up to Dr. Curl and, in the most innocuous manner, asked my question. He wavered a bit, then explained that since the depression is often immediately connected to the personality disorder, and that, therefore, therapists do try to work on the personality disorder. I had him confirm for me once again that this specific part of the treatment happened without the patient´s knowledge. He confirmed it for me.

I could now have, equally innocuously, asked him if this wasn´t a violation against the patient´s rights. I don´t know if there is a legal basis for my complaint, but, seriously, treating someone without his informed consent is unethical, particularly when it is against something that touches the core of who he is: A personality disorder. I didn´t ask, though. I just smiled at him, thanked him and left.

Why did I not ask? It´s quite simple, really. I didn´t want to hear any goddamn excuses. He could have told me a lot of things, but none of them would have alleviated my feeling of betrayal and humiliation. And besides, I suddenly felt very sorry for him. I had been deceptive as well, my entire going to this lecture was deceptive. I had exploited his willingness to be honest to his students. Well, maybe in a few months I´ll wonder why I was so scrupulous, but now I didn´t want to make him feel betrayed and humiliated. He doesn´t deserve my vengefulness, anyway. He is not the one who hurt me. He helped me, though unwittingly.

Once outside, I staggered a few steps away from the building and just stared into the void. I cannot recall how I felt. Eventually I went to some reading hall and wrote everything down. Originally I was going to post it all, but it is really hard to make sense of it. Want a sample?

So I went outside and a few steps away from the building, and from everybody. And I just stood there and stared into the void for a few moments, feeling like there should be a storm of feelings going on inside of me, and in fact feeling unable to tell what I felt. I wish I could say that this was a dramatic, life-changing moment, but it was not. Will not be. It shook me up to some extent, yes. And it made me feel like I had quite a good reason to cry now. I didn´t, however. I wanted to hold on to that feeling. Just to feel anything. Feel alive for a few moments. Believe that I had finally proven that I have been wronged. It would be great if I could believe myself. Others won´t get it, I know that by now.

If there was a mixture of feelings, though of feelings I could barely grasp, it would look about like this:

An almost ecstatic, triumphant euphoria. Like I had finally found the answer to a deep, mysterious, incredibly important question. I could not rationally explain why it is so important, but it definitely is.

A sense of complete hopelessness. I know I´m still alone in believing I was wronged, or in believing this whole practice is not alright. I know I must not share my opinion or knowledge with the wrong people or they will demolish me all over, supposedly all with the best intentions.

A sense of tiredness, sadness, brokenness. I get a glimpse on just how hurt and destroyed I am, because for a second it doesn´t matter if I deserve it or not.

A glimmer of compassion for myself. Feeling like I deserve to be taken care of, and be it just by myself. Feeling like I ought to take care of myself. Feeling like I need to mind my needs. Feeling like what I need and want might be important. Feeling like it might be worthwhile to take care of myself. Take care I don´t get hurt.

A voice formulating this blog entry, and a feeling that I must be a complete fake if this is what I think about in such a moment. A feeling like I must be narcissistic beyond redemption. And empty. Completely empty, like all of my feelings are pointless, meaningless, shallow, not really there. Like there is no need to mind them, huh?

So, I can shed some light on this euphoria thing. Have you ever read Orwell´s 1984? It is a book that I downright worship, and for some reason I can relate to a lot of the psychological mechanisms described in there. Main protagonist Winston Smith has a moment very similar to what I experienced on Thursday. For a few moments, he holds physical evidence in his hands that the past is being falsified, and that the confessions of the thought criminals are lies. Though he has known or at least suspected this before, having seen this piece of evidence is of great significance to him. It proves to him that he is not mad. Up to that point he had always realized that the past had been falsified because he remembered things differently than the Party stated they occurred. But how could he ever know if he could trust his memories? Maybe he is just delusional, after all. Well, having his memory corroborated by physical evidence, he knows he is not delusional. And this is similar to what happened to me on Thursday: I know that I can trust my perception. I´m not distorted or delusional, either. My perception of Dr. Stoneface was right all along. I may never be able to prove it to others, but I know it for myself.  I´m not insane.





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