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This was one of the last pieces to be cut from “Crazy.” It seemed overkill to write about validation and empathy in separate chapters, so I went with the latter and decided to deep six this piece. Fortunately, you can still read it if you so choose (for free!):
Years ago, when I worked in the nursing home, I would often try to engage a very angry and disinterested woman in therapy. While no one was required to participate in treatment, I usually made multiple attempts to offer my services to the residents. The treatment was covered (in full) for them, and sometimes after my gentle hounding over a few weeks they would get comfortable and look forward to a visit from me.
This woman, however, was not buying anything I had to sell. Upon entering her room, she would often simply shout, “get the hell out!” On one occasion she threw a bedpan at me and, at another point, threatened to “remove my cock and flush it [down the toilet].” I was younger then and, seemingly, enjoyed being verbally abused, so I would simply smile and say ridiculous platitudes such as “okay, I guess you’re not in the mood to talk right now. Maybe I’ll come back next week!”
The next time I entered the room, the woman (who was bedridden) was already screaming out in pain. “Get me painkillers, someone needs to get me painkillers!” Her voice ebbed and flowed in volume so that, without a medical chart and an adequate history, it was impossible to tell if the woman was experiencing pure pain, withdrawal, a sort of delirium, simply seeking attention from the staff or possibly some combination. Quickly, however, her eyes met with mine and her voice become more coherent and even.
“You. Need to get. Me. Painkillers.”
“I’m sorry,” I said. “I don’t do that. I’m just the Psychologist. I can get a nurse for you.”
“NO!” she said. “You get them now.”
“I can’t do that,” I repeated. “I try to help you through talking, not medicine. That’s not my job.”
“You’re job,” she said, “is to do what I say.”
“No, that isn’t correct, and I’m sorry you feel that way. Let me get a nurse for you.”
As I turned and began walking, I heard, “oh sure, sure,” she said, and waved an arm with many bedsores on it. “You just go, leave me, go home to your perfect life.”
I stopped and thought about my perfect life. At that point in time I was probably 31 years old and had about $376 in the bank. I had just gotten dumped for “not being ambitious enough” by my girlfriend because I wasn’t mentally prepared to begin a full-time private practice. My recent experience with Andy left me feeling like a professional cripple and I was, at the time, on a slow but steady pace toward developing an alcohol problem if I wasn’t careful.
I turned around. “What did you say?”
“I said to go back to your perfect life. You probably have a great wife, a pretty car, kids, everything. I have nothing. Just look at me.”
It would have been foolish to even attempt to quantify our quality of life on a Tale of the Tape. This was a woman who had no family, spent most of her time in a bed in a nursing home, in poor health and had over 80 years of poverty. I came from at least a somewhat intact middle class family, I had a doctorate and a truckload of potential in my professional life. And yet, I was angry. Why?
This woman didn’t truly know who I was or anything about me. Given that she’d never heard a word I ever said (as she was always yelling over me), I could have been a case manager or home health aide making virtually nothing for incredible demeaning labor. Yes, I was younger, but that didn’t guarantee that I was in good health. I could have had no family whatsoever, and I certainly didn’t have a wife, kids or a nice car. In short, she profiled me and was wrong in many ways.
More recently, I had a discussion with a client about the concept of validation. I argued to her that we are hard-wired to need validation when we are experiencing any sort of psychological pain. We need to be told, either by ourselves or others, whether rational or not, that we are entitled to feel what we feel. It’s this message that allows us to look at our problems in a more objective light. I have clients who make well over $500K per year, drive luxury cars, live in mansions, drink the finest wines and have great relationships with their spouses, children and friends. On the surface, they have it all. And yet, something doesn’t feel right. They’ll wonder if they need more money, or they may become anxious about losing their partner to a younger, better-looking rival. Will their children be successful in life, how will I keep my cholesterol at a reasonable level, how can I cut down my hours at work so I may spend more time with my family? The list goes on and on.
Do these people ultimately need to get their cognitions in check if they truly want to live fully? Of course. But pushing that point is skipping an important step, the act of validating. And if you know anything about me, you know that my overarching philosophy on life is that we are all “crazy.” It’s only when a person hears, “these problems are yours, you are allowed to feel how you do, that’s your right,” that he/she can begin to consider, “maybe it’s not so bad?”
It was not the woman in the bed’s job to validate my personal issues, far from it. However, she made premature decisions about me and used them against me. I didn’t have a chance to respond to her because a nurse came in and began attending to her needs, and every subsequent effort by me was met with a dismissive hand. This is one of the biggest regrets in my career. We could have used this experience to help her see that not everyone who seems to be successful and put together is, in fact, like that. I would have self-disclosed some aspects of my life to her. Would that have helped? We’ll never know. But it’s truly unfortunate that the woman rejected me, permanently, on variables that were not only false, but ones that we could have discussed to bring her perspective on how everyone suffers in their own way.
I suppose I can only hope someone else was able to get that message through to her.