Monday, August 10, 2009

Summertime fun? Meeting DT

Summer is a time of leisure and a touch of laziness where you do just enough to get by in order to savor the down time. What did I do this summer? I took on 3 new cases! Way to take a load off, huh? Anyway, since I haven't talked about my cases in a while, here's a lil nugget to get things started.

DT, or as I fondly call her Deet (yes, like the toxic chemical), was referred to me from a colleague who I consider one of the best therapists in our program. She let me know immediately that Deet was not easy. Upon hearing this I knew immediately that this would be an Axis II case: personality disorders. Well, actually, to be accurate, Axis II is really about "underlying personality conditions" (i.e. longstanding traits) and it includes mental retardation. What would I have given for Deet to be mentally retarded! By their very nature, personality disorders are extremely difficult to treat. For one thing, the "disordered" individual usually doesn't think that there is anything wrong with them. Quite the contrary, they often think that they're great...and better than least when you're dealing with the narcissistic types. As luck would have it, Deet was diagnosed by my colleague as having Narcissistic Personality Disorder. Awesome. "You probably won't like her at first," says my colleague, "I sure didn't." This from someone who I think may be the kindest person I know. Double awesome.

As you may recall, my last run-in with Axis II was with Mrs. P. I have since terminated her case. I miss her feisty, albeit racist, comments about her caregivers. There was something truly endearing about her that made me not hate her so much. Maybe it was the fact that she was closing on 90 and just waiting to die, I don't know. I hoped that Deet would be a tragic hot mess, like Mrs. P, so that I wouldn't hate her immediately. She'd grown on me, like a fungus (thanks, Mermaids).

So, I met with Deet. She's a small specimen...tiny in every which way and I felt like a monster in her presence. She looked me up and down...and I mean UP and DOWN, no inch went unexamined. This made me feel uncomfortable, which then made me angry. I thought to myself, I don't like her and she hasn't even said a word to me. I then gave her a once-over, my instinctive reaction when feeling judged. Not very mature, I admit.

What are her presenting problems?
1. She has trouble with her relationships (shocker). She longs for a romantic partner but that hasn't happened. According to Deet, people just don't get her, especially "non-creatives". These are people who do not have careers in the arts and, therefore, shouldn't exist. She also doesn't have very many female friends. Allegedly, women don't get her, either. Whenever a woman says that she has trouble having female friends, a red flag goes up in my mind. It usually means that they have trouble communicating and may often put the ole foot in the giant gaping mouth.

2. She's stuck in her career: a struggling composer. She's been working on an epic opera about parrots for the past 20 years. Yes, the past 20 years. "What I do is really hard, you see. How can I make you understand. OK, it's like imagine you're working towards your PhD, only it's really really hard. Imagine you're doing that for 20 years. You know what I mean?" In my head, I think: No, I don't know what you mean. After all, I'm just a silly PhD student working on a useless and mindlessly easy degree. It took all the strength in me not to deck her. No wonder no one likes her. She’s not likable. I try to shift my inner monologue from the hateful/judgmental place to a more empathetic one in order to stay calm and acknowledge that this person is in pain and needs help...lots of help. Maybe I'm not qualified? Maybe I should transfer her? (teehee)

As she progresses with her tales of woe, letting me into her darkest corners of her current life, her childhood, and her most intimate thoughts, I felt my muscles ease up and I started to really feel for her. She's sad, lonely and scared. Who wouldn't have their defenses up when first meeting someone in that state. I actually had to admit that she could be somewhat amusing when she wasn't being hypercritical of everyone in her life and a total hater. The problem is that she thinks she’s pretty awesome just the way she is. Um, I guess she was sick the day they taught social skills in kindergarten. It’s funny how therapy often acts as make-up classes for missed kindergarten days—only there’s no milk and cookies or nap time. Sigh.

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