(This is an excerpt of an illustrated memoir, This is Your Marriage on Drugs: A Memoir about Marriage, Methamphetamine and Mental illness.)
Therapists We Have Known
Luciano: You should draw a picture of me lying on a couch in a therapist’s office with a balloon saying, “There’s Always Been Something Very Wrong With Me” coming out of my mouth, and an IV pole, with an IV line with Self-Absorption flowing through it.
Stephanie: Huh. You mean, the “self-absorption” is in the IV bag? And goes into your veins?
Stephanie: But wouldn’t it, like, already be in your veins? Does it recirculate? Would that be a different machine? Is there such a machine? I’m having a hard time picturing it.
Luciano: I don’t know, Stephanie! Okay, okay: Draw a picture of all my therapists as those dancers — you know, the ones who stand in a line and kick their feet in the air.”
Stephanie: You mean can-can dancers?
Luciano: The ones who kick their feet in the air.
Stephanie: Can-can girls?
Luciano: Yeah! No! I don’t know! The ones who kick their feet in the air!
As a kid, I was fascinated by psychology. The first “chapter book” I ever had read to me — by my father, when I was about eight — was Catch 22, Joseph Heller’s darkly comic satire about the madness of war. In the book, Yossarian, an American Air Force bombardier who is trying to get out of flying combat missions on the grounds of insanity, is told “There was only one catch and that was Catch-22, which specified that a concern for one’s safety in the face of dangers that were real and immediate was the process of a rational mind.” In short, you could be let out of flying the missions if you were crazy, but asking to be let out of flying the missions on the grounds that flying combat missions was crazy proved you were sane, thus you had to keep flying the missions.
I was gripped by the ideas in Catch 22; the question of how you know if you’re insane or not; the way it depicted the adult world — and the adults in charge of it — as absurd. Also, I was comforted to know: The world was crazy, and at least some adults knew it — I wasn’t alone.
My fascination was further fueled by Late Show movies like The Three Faces of Eve, The Snake Pit, and Whatever Happened to Baby Jane?, not to mention the acts of real-life criminal insanity that seemed to be everywhere during my childhood: The Boston Strangler, Richard Speck, Charlie Manson. I also watched the concentration camp liberation films that were broadcast on public television over and over again. And, for some reason, the framework I put it all into was the question of sanity versus insanity, rather than good versus evil. Like my mother and father, my organized-crime-family relatives, these people weren’t evil — they were just crazy. That was the reason such horrible things could happen.
One of the first books I ever bought myself, when I was ten, was about Salvador Dali. I was fascinated by the surrealist images, the melting clocks — the idea that such strange things could exist inside someone’s mind and could be painted, examined, and brought forth for others to see.
Watching John Huston’s Freud: The Secret Passion at around that same age convinced me that I wanted to be in psychoanalysis: Psychotherapy seemed cool, modern, exciting. I wanted to lie down on a couch and talk to someone about the strange things that happened inside my head, tell them my secrets, have them interpret my dreams. Maybe I was insane. Maybe I would end up in a strait jacket and be sent away to a mental hospital.
Back in New York after rehab, I held firm to my commitment to stay away from dope. Shaky and suffering from the effects of post-withdrawal, I immediately set out to find a therapist from a list of recommendations from friends and acquaintances. After meeting with a number of prospects, I arranged a consultation with an odd-looking woman who spoke with a thick New York accent and had a big red afro. Though I initially chose Babette mostly because of how much I had disliked all the other candidates, I quickly came to like her. She was smart and could be very witty: When making a point, she might quote Freud, Jung, Sartre, Allen (Woody) or Alan, her boyfriend of 10 years. She was upfront about the therapy techniques she was using. She never answered a question with a question and she didn’t play the staring game to get me to break when I didn’t have an answer to a question. Most importantly, she made me feel like a partner in the process. In the beginning, it was exciting to work with Babette, examining all the pieces of my fucked up life, trying to make sense of it all. It was as if we were arranging puzzle pieces by color and shape, preparing to tackle a whole 5,000-piece jigsaw magnum opus.
Anyone who’s ever been in therapy knows about how one surreptitiously checks out the surroundings, examines the artwork and knickknacks and photographs, trying to glean information about the therapist’s life, ascribe meaning to his or her decorating choices. It took me a couple of sessions — I didn’t want to appear rude — to ask Babette what the deal was with the rabbits. There must have been more than a hundred of them — stuffed and carved and hand-blown and painted — arranged around the room.
“I collect them!” she said. “People give them to me. A client brought me this one from Russia,” she said, picking up a matryoshka rabbit-doll and removing its top half to reveal the smaller rabbit inside. “Isn’t it cute?”
“You collect them?” I asked, ignoring the question. “Why?”
“It’s fun!” she exclaimed. To my skeptical look, she said, “It’s a hobby! Don’t you have any hobbies?”
“What do you think?” I think I responded.
“You could collect something!” she said. “Coins or stamps. Well, probably not….” Then she told me she had an entire room in her house just for rabbits.
“Well, I think that’s really weird,” I told her.
“Well, I think you’re really weird!” she laughed.
Another time I walked into Babette’s office and found her wearing a large pair of black sunglasses. The fifty-minute session passed without a mention of them. Finally, she said, “Aren’t you going to ask me why I’m wearing sunglasses?”
“Why are you wearing sunglasses?”
She took off the glasses to reveal two huge black eyes that were the result of cosmetic surgery.
“I knew that you’d approve, since you love self-improvement,” she said.
“Of course,” I lied, pretty sure I’d never said anything like that.
I continued in therapy with Babette for more than thirteen years — meeting with her in her office, in her car, in her home (it wouldn’t be inaccurate to say that Babette had some boundary issues), and, later, over the phone, after Stephanie and I moved to Salt Lake City.
At a certain point, near the end of that time, Babette stopped being my therapist and we became friends. We never exactly talked about it — there was no formal termination of therapy. I think she had simply decided it was time to cut me loose despite the fact that I still had a lot of problems, kind of like a high school principal saying “Let’s graduate this twenty-year-old senior, already.” Maybe she knew she’d done just about all she could for me. I know that she saw my ability to remain drug-free, to find success in harm reduction, and to sustain a relationship with Stephanie as proof of significant progress. And, since she’d always explained my tantrums and mania away as eccentricities, those weren’t issues that needed resolving.
Also, I had begun to see other mental health care providers and doctors, by that time — a number of them, actually — who were trying, not very successfully, to identify what was wrong with me. Not that the lack of diagnosis kept them from writing prescriptions for me. All the doctors in Salt Lake City wanted to put me on something, and I knew Babette didn’t agree with that approach. When I’d first started therapy with Babette, a number of her other patients in group had prescriptions for various medications. I’d wanted to be medicated, too — just a little something to take the edge off the mess I’d become. Every time I’d ask Babette, though, she’d say she didn’t think drugs were right for me. So, maybe discontinuing the therapeutic relationship was also acknowledgement on Babette’s part that my care was out of her hands.
Right around that time, she was diagnosed with breast cancer — which made the transition to friendship easy and natural, as Babette suddenly became the patient, and our relationship became more equal from that point on, with both of us calling to check in and ask how the other was doing.
I’m going to preface everything I’m about to write with the acknowledgement that another person’s therapy is none of anyone else’s business.
Given the severity of Luciano’s problems — the ongoing mystery that his condition presented to the succession of practitioners who couldn’t unravel it, diagnose it, or put the pieces together to form an effective course of treatment — as the person who knew Luciano the best, observed him the most, and knew the fullest version of his larger story, it surprised me that throughout the whole journey, no one ever thought it was important to ask me — about anything. Even when I’d accompany him to an appointment, as I did a few times after things had gotten really bad and I think he didn’t trust anyone, including himself, to make a good decision regarding his care, I wasn’t treated so much as a resource as — well, I don’t even know what: A silent caretaker? Some weird lady who’d driven Luciano to his appointment and accompanied him into the office? Kind of like a mom, but a wife?
And it’s too bad (to put it mildly). Because my input could have helped fill in some important gaps for Luciano’s providers. For example, if the psychiatric nurse to whom Luciano was referred, when the depression he was suffering from got really scary, had been curious about what symptoms his closest family member had observed, maybe she could have avoided the misdiagnosis and disastrous course of treatment that cost Luciano his job, his health insurance, and his ability to function, led to an intractable Klonipin addiction, and left him much worse off than he’d been before.
“Look at this,” he said, one day, after returning home from an appointment. He sounded a little abashed — a clue that something was up. Any time Luciano doesn’t exhibit the impression that he knows exactly what’s going on, and everybody else is an idiot, is a notable moment. He handed me a piece of paper.
“What‘s this?” I asked.
“It’s the screening tool Jody gave me when I first started seeing her.” He was well into his treatment with her by this time — probably on his eighth or ninth prescription cocktail.
The document was a standardized worksheet for identifying bipolar disorder. The nurse had dug it out at his appointment to go over with him again — no doubt trying to get to the bottom of why he was getting worse and worse under her care.
I scanned the questions:
Has there ever been a time when…
- Thoughts raced through your head and you couldn’t slow your mind down?
- You were so irritable that you shouted at people or started fights or arguments?
- You were so easily distracted by things around you that you had trouble concentrating or staying on track?
- You did things that people might have thought were excessive, foolish, or risky?
No, no, no, and no, he’d answered. The rest of the questions, too, were answered exactly the opposite of the truth
“Why do you think I did that?” he asked. He couldn’t reconstruct it, and I couldn’t guess. What was even more puzzling was that he’d gone to this provider, initially, because he was scared of what felt to him like an impending mental breakdown, desperate to find out what the hell was wrong with him? So why would he lie in the initial screening?
Though I just realized I’m leaving something important out: As with many people, Luciano was affected by the stigma of mental illness. He searched high and low, for many, many years, to be anything but clinically mentally ill. Crazy, maybe — but only in his own, unique Luciano way, which was a story he controlled. Maybe that was the reason he’d lied on the screening form: Maybe he’d gone to the nurse hoping to get the drugs to fix himself, without actually having to get the diagnosis.
Some of Luciano’s therapies directly involved me. The couples counseling, for example. While I have respect for the therapeutic process in general, in this case it just, frankly, let us down.
It wasn’t that our therapists weren’t good — though, on second thought, I would have been OK with skipping the one who made us walk around each other, waving a silk scarf while reciting things we appreciated about the other. Or the one we only saw once and agreed not to go back to because Luciano couldn’t get past the hole in her shoe, visible when she flexed her foot across from us. I stopped listening when she remarked in the getting-to-know-us phase that of course we had a hard time getting along: We came from two very intense cultures — Italian and Jewish — and so it was normal to have a volatile relationship, marked by bitter, violent fights.
It was only later that I could see that the real reason couples therapy didn’t work for us was that we were trying to treat the wrong problem.
I mean, I did know it, in a way — and, again, if anyone had listened even half-carefully to me, he or she might have picked up on the fact that underlying Luciano’s “anger” problem and my “control” problem and our “communication” problem, was an undiagnosed mental illness that made all the rest of it impossible.
The way it always went was I would try to explain what I saw as the underlying issue: “Luciano has this anger problem. It’s like there’s something wrong in his brain. Whatever it is that allows a person to experience a moment of difficulty without instantaneously freaking out. There’s no room between the incident and the anger for us to even attempt communication. You can give us ‘techniques’, but we aren’t going to be able to practice them because of this very specific thing.”
Furthermore, I’d say, trying to do so would create an explosive situation at home, with me as the target. The therapists’ response to that, uniformly, was No — that’s not going to happen, because there will be ground rules.
Then I’d tell them that they could give us ground rules till the cows came home, but, with whatever it was that Luciano “had” — this condition that everybody was trying to make me think I was crazy for insisting existed — there were no rules.
It didn’t help that the Luciano who showed up in therapy wasn’t the one who screamed at me at home. That I’d never actually even met the guy sitting next to me — the one listening receptively, agreeing to the rules, claiming that he understood exactly. He didn’t actually exist, except in this moment, in this office. And if he did exist, I wouldn’t want to meet him, because if he was the same person as the Luciano who’d lose his shit at home and claim not to be able to control himself, then I was pretty sure both of them were psychopaths.
Luciano worked with his old therapist from New York, Babette, over the phone, after we moved. I could hear and see him, sometimes, through the windows, pacing back and forth, to stay in cordless range, on the sidewalk outside our house on a Saturday or Sunday.
He’d speak loudly, non-stop, excited, gesticulating: Even if I couldn’t hear the content, I was familiar with the delivery, and I guessed that he was probably telling her stories — about work, most likely, as that had become the topic that interested and consumed him most. And while there was no need to interfere, I did often think He’s definitely the one in charge, here. It was my impression from what he told me about his work with Babette that she didn’t kick his ass, very much, and maybe didn’t press him to go to places that were hard for him. And I was also pretty sure that he left a lot out. If I had to guess, I’d bet that Babette never had any idea of the trauma that was going on in our house. Still, I was grateful that he had her to talk to. She was someone who’d known him, at that point, longer than I had; and, in some way, she was one of his oldest friends.
Babette never actually diagnosed Luciano with anything — though at some point, she’d floated the idea that maybe he’d suffered Post-Traumatic Stress Disorder from the way he was raised. Luciano was skeptical, but I remember feeling attracted to the idea of a diagnosis, an actual disorder, to explain the inexplicable: How someone who claimed to love me and value our family so much could be, at the same time, perpetrating such hurtful, destructive, devastating acts. There was some relief to me in the idea that he was ill, and not just heartless.
When I met Luciano, on one of our very first dates, after he’d been regaling me with stories for a few hours, he stopped and grinned at me and declared: “My life’s an open book!”
“And you sure do like to read it,” I answered, making him laugh — because of course everything I did, back then, was delightful.
In real life, Luciano doesn’t like silences. When one occurs, he’ll usually say something like, “Anyone seen any good movies, lately?” Or he’ll start talking in imaginary-character voices or launch into a story.
It was my impression that that was the way he approached therapy, too. From what Luciano told me, he’d pick and choose what he wanted to talk about. He canceled more appointments than he kept, especially if his previous session had been difficult. I was always surprised at how easily he got away with this — and I wondered if his therapists understood that behind the huge personality and the never-ending stories were all the things Luciano didn’t want anyone to know.
I suppose this was the Luciano Paradox, the Catch-22: His story contained the clues to whatever was wrong with him, the symptoms of his illness. However, his story — which was a great, entertaining story — was also designed to get you off the track, distract you from the problems.
And he never told anyone all the pieces of it.
Which went hand in hand with the Stephanie Paradox: I was the only one who knew all the pieces. And nobody ever listened to me.
In the years after I stopped seeing Babette as a client, we’d get together occasionally. I would call her when I was in New York for work and we’d meet for coffee or dinner or a visit. Once, we had Chinese food across from the Empire State Building. Another time we had lunch at her home, and I met her new dog and said hi to her new husband — she had finally married Alan — and she showed me the newest additions to her rabbit collection.
It was a hard time for both of us. She’d had a recurrence of her cancer, a double mastectomy, and was really sick. At home, I had been misdiagnosed and misprescribed medications for unspecified mental illness, seemed intent on destroying all of my relationships, and was slowly committing professional suicide. And while Babette knew my life had turned to shit, we tacitly agreed not to talk about my problems anymore, focusing instead on her chemo treatments.
Therapists make a good part of their living by listening to people’s stories, and mine are exciting and colorful: Telling stories is pretty much my only talent. And storytelling worked out well for Babette and me for a long time. Probably too long.
Babette never diagnosed my bipolar disorder. She did tell me, once, that she thought I was suffering from PTSD—which I didn’t believe then, and don’t believe now. When I told her that I’d been diagnosed with bipolar, though, she agreed with the diagnosis. She also told me that she thought I was being extremely over-medicated, and to be careful.
Looking back, I can see that Babette probably wasn’t the right therapist for me. There were no breakthroughs. No epiphanies. I don’t even know if I made much progress under her care. But she was the right person in the right place at the right time. Babette was someone I could talk to, who quickly taught herself how to track the output of my weirdly-wired brain. She could follow and understand me. I think that’s what I needed back then — for someone to listen to me as I caught my breath between one chapter of my story and the next.
Babette died during the time that I was using methamphetamine and living in Cambodia. We’d been exchanging emails, when suddenly hers stopped. I didn’t find out for sure until I returned to the States. I regret not having been able to attend her funeral. I wish I could have sat shiva at her house with her husband, step-children, brother and sister-in-law. It would have been nice to see those rabbits one last time.
Luciano Colonna is an international expert on public health and policy and has worked as a consultant to organizations, world-wide, on drug use issues and HIV. Luciano is currently exploring his personal experiences with drug use and bipolar disorder, and their collateral damage, in this memoir. Follow him on Twitter, here.