A New Perspective

Walking into Gail’s office suite I noticed a fairly large sign on the wall of the waiting room. “DO NOT MOVE THE CHAIRS IN THE WAITING ROOM!” Apparently some clients have been manipulating the chairs to be able to put their feet up on the coffee table, causing Gail some unnecessary anxiety. I’ve always known that Gail is particular about her practice, but the capital letters in her admonishment suggested to me that something more was at play here. Being in a joking mood my first response was to turn one of the chairs around, scurry to my office and watch her exacerbated expression through a crack in my door. However, I noticed on the floor a power drill and some thick bolts.
She’s actually going to screw the chairs into the floor.
This unusual behavior got me thinking about Gail as I waited for my first client of the day to arrive for session. Gail has a cleaning woman come basically every day of the week to dust and disinfect, regardless of how dirty the office is. She has a separate compartment for her food in the employee refrigerator with a polite but firm “PLEASE do not touch anything in this drawer.” I never see her shake hands with clients, and on the day I had run thirty city blocks to get to the office in the sweltering heat because I couldn’t catch a cab and asked her for a sip from her water bottle, she refused.
Oh my God. Does Gail have OCD?!


The fact that Gail might have a psychological disorder in and of itself isn’t surprising. As we’ve learned, mental health providers have perhaps just as many difficulties as the general population: Dr. Pete has Social Phobia, Dr. Steve probably has Narcissistic Personality Disorder and I have enough going on that I could use my own book beyond the DSM-IV: The Idiot’s Guide to the Innumerable Neuroses of Rob Dobrenski, Ph.D.
No, what is surprising here is my newfound feelings for Gail. Prior to today, I viewed Gail as a meticulous (i.e., annoying) clinician who insisted that my paperwork be impeccable and that I cite at least three psychological journals that support every therapeutic intervention I discuss in the unproductive group supervision sessions. But now that she may have a diagnosable condition, I suddenly feel empathy for her.
This is disturbing. Is this how it works? When someone does really irritating things you feel angry, but when that same behavior escalates to the point of dysfunction you throw a label on it and see them as ill? That must be at least somewhat true for me. When Tom Cruise first bashed Psychiatry I was pissed. But as he acted more and more bizarrely, I started to feel sorry for him. Is he crazy? Has he been brainwashed? Could Scientology be a mental illness?
We see the same issue in our legal system. While “Not Guilty by Reason of Insanity” is rarely a successful plea, it does suggest that if your behavior is so outrageous or out-of-bounds you must be ill or else you couldn’t have done it. Does that mean that psychological problems have some sort of cut-off point? If you kill someone in a less than truly horrific way, does that mean you’re more mentally healthy?
Until we develop dipsticks to put into someone’s brain to measure how “ill” someone is, these questions have nothing more than speculative answers. However, I do see myself being at least somewhat more tolerant of Gail’s previously-viewed annoying behaviors. They’ll still bother me I’m sure, but because I know this “thing” about her I think I’ll be a little easier on her in my own head. I’d like this to be the case with everyone: the car repair guy who tries to rip me off, the woman who doesn’t hold the elevator for the elderly person, the man who bumps into a child on the street and doesn’t apologize. I’d like to look at them just a bit differently, whether I see them as having “issues” or not. But for now, once again, I have a lot of work to do.

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21 Responses to “A New Perspective”

  1. Charles says:

    Unless greed is a mental disorder, those mechanics don’t have any mental illnesses.
    Did you at least try to turn a chair around and drill it into the wrong place?

  2. Drew says:

    Rob,
    Interesting post, and a provocative question – should I let my knowledge of one’s mental illness color my perception of them?
    I think it’s also interesting to consider how our reaction to them reflects on us.
    I have a friend, a guy who was part of my very close group of friends, who is kind of strange. Everyone perceived him as just that – kind of strange. He had a quirky sense of humor and at times exhibited profound immaturity or a lack of self-awareness, but nobody would have called him sick.
    Then, one day, his mind just collapsed and left him completely detached from reality. He called me and two other close friends to come over to just talk to him, and I remember feeling profoundly frightened when I walked into his apartment. His face was emotionless, his eyes were just blank, and he kept rambling nonsense jibberish like “we are all among the stars and i must discover the code to unlock the universe.” This was not a joke – he was batshit crazy.
    His family had him committed and he ended up being put on some strong anti-psychotics. We found out that he’d had two previous psychotic ‘breaks’, once while he was in college and once when he was in high school.
    After he got out of the hospital, we hung still out, but often he would just sit and stare into the distance with the cold dead eyes of a mannequin.
    Two years and one more psychotic ‘break’ later, he’s pretty much back to the old guy he used to be. Most of us accept him for what he is and see his illness as just a small part of who he is. The last time he broke with reality was much less scary.
    But one of our friends, a profoundly selfish and narcississtic guy, refuses to believe our sick friend is really sick. He adamantely believes that he is only pretending to be sick to get attention. After that initial break, this guy basically just wrote our sick friend off. He actually expressed a feeling of hurt that our sick friend would go to such lengthes to get attention.
    I think the point of telling this story is that the way we deal with others’ mental nuances reflects much more about our own personalities. You feel empathy towards Gail probably in no small part because you are a caring and empathetic person. My selfish friend feels disdain and disbelief towards my sick friend because he is a narcississtic and insensitive asshole.

  3. Robin says:

    great story Dr. Rob! Today a woman skipped the whole line in the Banana Republic and I didn’t say anything. Does that make her mentally ill or me?

  4. Donika says:

    Awww, I love Dr. Rob with a soft spot. And I’ve been demanding that dipstick for years, at least with psychiatrists, not psychologists. You’re the kind of therapist I’d want for my closest friends. Believe me, they need you. Hehehe.

  5. Amber says:

    Before you even mentioned it, OCD flashed through my head. She sounds a little extreme, this Gail.
    I truly think, though, that everybody has a little OCD in them. We say we’re “anal” about something, but that’s easier than saying we have OCD.

  6. Jenna says:

    Robin, that makes her a bitch.

  7. John Smith says:

    To some degree, aren’t all personality factors chemical in origin? I personally don’t believe in free will, and most disorders seem to be a difference in magnitude, not type.

  8. Matt says:

    Dr. Rob,
    In Gail’s case, she could be suffering from OCD, but then you have to ask, although an illness, is she taking steps to control herself? If not, how much sympathy should you have? If someone got an infected cut because they never washed it/used a band aid, you would call them a moron. Should it be any different for someone who is letting thier neurosis run wild?

  9. kate says:

    matt–do you have OCD? i imagine it might be a little hard to understand it if you don’t. even if you take steps to ameliorate the symptoms it’ll always sort of be there, like a little neurotic voice sitting on your shoulder compelling you to check your keys 50 times before you can leave the apartment.
    i’m down to checking my keys about 3 times at this point, but if something’s going on in my life that stresses me out, trust that i’ll be back up to checking them about 5-6 times. if it’s really bad i’ll go up to an amusing (to my friends) but seriously annoying (to me) 10. sometimes i force myself to just NOT do whatever my brain is telling me at any particular moment (NOT spill a drop of coffee on my left pant leg because i just spilled one on my right pant leg and my pant legs will be upset if they’re not both dripping in coffee stains and one of them feels uneven, and if my pant legs feel uneven then the sky might burst into flames and the human race would suffer the apocalypse), but sometimes it’s just easier to spill the fucking coffee.

  10. That is a very interesting post on social phobia! In fact, to find out more about social phobia, check out http://www.whatcausespanicattacks.com, they have many great articles and tips to guide you.
    Dr. Rob Note: This post isn’t about social phobia, and this person is clearly pimping his or her site (which is about panic attacks and not even about social phobia), but if there’s anything on there that might help, so be it.

  11. notkate says:

    I like how Kate claims OCD yet is unable to use proper grammar and sentence structure.

  12. kate says:

    it’s not that i’m unable to write without proper grammar and sentence structure, i just prefer not to. it sounds better this way, and although you’d probably hurl if you read any of my ‘poetry,’ you’d feel pretty stupid if you tried to understand anything academic i’ve written.
    anyway i realize ‘notkate’ is just trolling, and poorly at that. why would i claim to be OCD if i weren’t? it’s not exactly my favorite personality trait. and OCD manifests differently in everyone–if you could see the state of my room you’d understand i’m not of the ‘anal-retentive’ typology. feel free to come to one of the lectures i TA in abnormal/freudian personality and i’ll educate you about the different types of OCD symptomatology (most notably ‘anal-expulsive’)..
    on a bigger and more relevent picture, yesterday’s post got me thinking about the obsessive component of OCD character structure as it relates to catatonic schizophrenia–like the overwhelming imagery of doom, death & destruction that are typical in both. i know there’s some research going on to link the two, but i’ve read none of it. suffice it to say a lot of my obsessions involve death, guns, fire, nuclear war, etc., etc.,…..while others involve being locked out of my apartment. i think the CBT technique for dealing with some of this stuff is to put a rubber band around your wrist and snap it whenever shit like this starts becoming overwhelming, but that always seemed a pretty assinine thing to do in the face of vivid jumping-off-a-bridge imagery..

  13. kate says:

    ps–i totally spelled ‘relevant’ wrong….*snaps rubber band*

  14. Wayland says:

    Gail…she’s the one who doesn’t believe in helping her patients to see a psychiatrist for medications they may need to take care of mental illnesses right? She’s a special one. Do you ever have a normal day, whatever that is?
    Dr. Rob Note: No, that’s “Allison.” See Group Supervision in the Archives.

  15. Wayland says:

    Wow, I totally messed that one up :-\ My bad on that one. I guess it doesn’t help that I only read it once and that was a while back. Maybe they should hang out.

  16. Avrila says:

    “As we’ve learned, mental health providers have perhaps just as many difficulties as the general population”
    I wouldn’t be surprised if people in the mental health field turn up with issues more often than the general population. The stress level is there to aggravate a borderline problem, and having lists of symptoms memorized gives anyone with even a shred of suggestibility plenty of material for “ack! I’m doing this and this! I wonder if I’ve got that! [subconsciously starts doing three other related things].”

  17. Tom says:

    I don’t really think you’re any nicer than me, but I often find myself not defending those with mental illness. I know as far as the Front Range of Colorado goes, Colorado Springs has an overnight facility, Pueblo has a large mental institution and I’m sure Denver is spotted with a couple as well, though Springs and Pueblo, I understand, don’t send very many people to Denver.
    The police have taken to removing people from my 7 Eleven and just dropped them off a few miles away. At least it’ll take, probably, the rest of my shift for them to come back.
    The only guy I had a mind to defend, and I’m not sure why as he was a total prick, was Tourette’s Guy. Just the other day, a customer and I were having a cup of coffee and talking about it. The guy says “I never liked that black guy who made those weird noises.” My response was “I never much minded him. He has Tourette’s Syndrome.”
    The sad thing about TG is that a lot of his weird mannerisms and behaviors are a direct reflection of society’s teasing. There’s a tattoo parlor on the other side of the block called “Freaky’s”; TG takes it as a direct offense, as if someone is calling him a freak (which probably has occurred) and spends hours yelling at the sign.
    I stick with observation more than anything.

  18. Sarah says:

    From Arrested Development:
    Lucille: Apparently mood-altering medication leads to street drugs…that’s what this very handsome young doctor said on The Today Show.
    Michael: ::pause:: That was Tom Cruise, the actor.
    Lucille: They said he was some kind of scientist.
    Thought you might appreciate it.

  19. I love the way you sound so passionate about what you are writing. Keep up the great work!

  20. Tom Cruise says:

    Hello, Dr. Rob! I noticed that you mentioned me in your post, and decided to comment since my handlers have left to defend the base against that evil Anonymous group.

    Scientology is not, in fact, a mental illness – it is a dangerous cult designed solely to suck dry the finances of its members and brainwash them into suckering others. You can find much more information about the cult (including fights against proven psychological treatment and drug rehab programs, toxic “purification” rituals, abuse by the President of the church, forced abortions, deliberate withholding of urgent medical services, child abuse, blackmail, assassinations, and the largest infiltration of the US government in history) at the website linked through my name (xenu.net).

    Dr. Rob: Thanks, Top Gun.

  21. Howard Slice says:

    hi, nice post. Also I was wondering what sort of theme your using for the website? I think it would work for a blog I’m going to start soon.