The Third Table

01: Jumping In

Chapter I

JUMPING IN

After Arthur Penn’s movie “Alice’s Restaurant” came out in 1969, Stockbridge changed. That was due primarily to Alice. Her little restaurant, immortalized by Arlo Guthrie, attracted hordes of hippies and curious onlookers. Once Penn’s movie came out there was no stopping the tourists.  Stockbridge was the mecca for people who wanted to stare at those they imagined were living a life of  adventure and freedom. The Red Lion Inn, which had never stayed open during the winter became a year-round operation and new restaurants opened, indicating that there were enough winter tourists to support them. The new patients who arrived at Riggs were several degrees closer to the hippies and Alice than to the image of mental patients that had dominated my imagination.

But in the early 1960’s after Labor Day the town always shrank to 300 locals, plus the Austen Riggs patients and staff.  In the winter we all relied upon Simms, the only local bar, for drinks, peanuts and occasional hot dogs.  Alice would meet us at Simms for many a late night– that is, before she had the brainstorm and opened her restaurant.I’d traveled back to Stockbridge several times after I left Riggs in 1968, so the day I arrived to see Dr. Ess White, I wasn’t surprised that a cop was moving traffic through the one light in town. I’d heard from a local gallery owner, Clem Kalischer, and Jarvis Rockwell, Norman Rockwell’s son, that the Rockwell Museum had caused more tourists to arrive. These folks wore Bermuda shorts and pastel sun hats and toted huge handbags; they did not appreciate Tanglewood and Jacob’s Pillow, let alone the gallery my friend owned. There was dissatisfaction with the way the town was changing, but to me it was still home.

Whenever I’d gone back to the Berkshires, I’d always taken a spin through the Riggs’s parking lot, but I’d never gone inside the Inn (where the patients lived) nor entered the Medical Office Building (MOB) where the staff worked. I was content to believe that my Riggs’s home was unchanged. Perhaps it was imprinting, but Riggs still felt and always will feel like my home. Now that I was going inside once again, I noticed that my hands were clammy. I wanted Dr. White to see how I’d turned out. When last I’d seen him there was more than a little doubt that I’d get my life together. Now I was married, had a beautiful little daughter whom I adored, had been teaching courses for the Connecticut Association for Jungian Psychology, had done several large stained glass commissions for synagogues, and was a working artist. I was stable, productive, and my feet were on the ground. I’d done years of Freudian therapy after leaving Riggs. Then in 1980, I found a brilliant Jungian analyst, Ray Walker, whose ideas, imagination and style made therapy a fascinating adventure.

This work was a better fit  for me than the Freudian work I’d done at Riggs. I’d taught courses for the Jungians like, The Animus: From the Heights of Apollo to the depths of Dionysus where I explored

Carl Jung

“the animus who is vital to feminine psychology and creativity. He is ally and foe, creative and destructive.” This was a language that the  Freudians didn’t use. After my experience with my carcinoid tumor and the rigid doctors at Yale, I felt as if I were being thrown back into a world which did not value me.  Nevertheless I felt torn between the two schools of thought and my two therapists from those different ideologies. What was it about the strength of that primal connection that had me traveling back to the MOB?

The fact that Ray encouraged me to go back helped me have the nerve to try and make sense out of those years. In the work I was doing with him, I had grown in ways that felt liberating – even revolutionary. For one thing, I was finding a real connection with the feminine which meant a connection between my mother and myself, as well as a growing curiosity and understanding about the patriarchy. I was also learning about the creativity and freedom of play.

freud[1]

Sigmund Freud

While Riggs had created a strong container which held me at a time of great distress, this new Jungian work turned many of my assumptions upside down and reinforced my femininity and creativity. Freudian concepts were part of the fabric in my family of origin and had been reinforced by Riggs. I began to wonder if those concepts were the voice of my own inner  negative animus? My therapy at Riggs was theoretically geared towards concepts like the Negative Mother Introject – a theory that, in retrospect, was not empowering or connecting. My Jungian work asserted that if you looked for the gold in a patient, you would find it. Working with Ray was creative and more transformative but I seemed obsessed on proving that Riggs would understand and honor my new experience.

A few years after starting work with Ray, I woke up one day and wondered what would happen if I were to quit drinking. Once the question reached my consciousness there was no way to let it go. Heavy drinking had always been something I took for granted. My family drank heavily, so it seemed perfectly normal that everyone had the same habits and life style. Five o’clock brought the cocktail hour for much of America, and as I grew up it was normal that my friends and I followed suit. Riggs too had a culture of drinking, and the staff and patients were equally rooted in that culture. What started as a giddy dare (to stop drinking) soon turned difficult. Ray was not completely supportive, thinking that a rigid morality would push the archetype of Dionysus into  massive rebellion. I had more important fish to fry, so I went to AA meetings to see if that might help me understand my anxiety. I never liked the meetings, although I found them useful and kept going. I also never identified with the title of Alcoholic. Nevertheless I knew I had a problem and decided to stick it out. Serendipitously, at an AA meeting I ran into another ex-Riggs patient, Janice, who was about my own age. She told me with a great deal of certitude, that she had been misdiagnosed at Riggs and that rather than being a borderline, a Riggs’s specialty, she had been an alcoholic. How strange, I thought, I never thought that my age group could be alcoholic. I knew we were heavy drinkers and many of our parents could be described as alcoholic, but alcoholism was an over-dramatic description of our problems. Furthermore, I remember agreeing with the staff that drinking was a symptom of an underlying problem. Either because I didn’t want to stop drinking, or because of some twisted cultural stigma, I preferred the diagnosis of mental illness to that of alcoholic. I saw alcoholics as weak, unconscious slobs, whereas a good stint in the loony bin indicated a truly creative mind. However, as I spent more time in AA, I saw I had plenty of misconceptions about alcoholism.

fitzgerald-89538

F. Scott Fitzgerald

Portrait_of_Eugene_O'Neill_2
martha-holmes-painter-jackson-pollock-working-in-his-studio-cigarette-in-mouth-dropping-paint-onto-canvas

Jackson Pollack

The functioning drunk was a social drinker no matter how much damage she or he created around them. I’d accepted the idea that artists were helped by alcohol that O’Neill, Fitzgerald, Pollock, or any number of other writers and artists couldn’t have been creative without booze. I linked romance with alcohol and rarely dated anyone who didn’t drink more than I did. But after a few years of sobriety, I came to see how I had been culturally conditioned to see alcohol that way and that when I drank, I was simply not present. I was disorganized and flippant, promiscuous, irresponsible, giddy, and insecure. Not drinking allowed me be present and stable. Was a great deal of my ” borderline personality disorder” in fact a symptom of my drinking? Had Riggs misdiagnosed me? Had I accepted someone else’s description of me? Anyway, I was at Riggs to see what was true. In the early 60’s there wasn’t the same knowledge about alcohol or drugs. What was their attitude now? Did they have a better understanding about women or did they still follow Freud and use his definition of the feminine mind? I’d read Jeffrey Masson. What did Riggs think about his discoveries about Freud’s letters? I certainly resonated with Masson’s perspective. As I walked into the MOB with all these thoughts bumbling around, the receptionist looked up, smiled warmly and said, “Hi, Mary. Wow, you’ve hardly changed.” I recognized her but couldn’t remember her name. She had been the receptionist twenty-four years ago and, it seemed, had been sitting there ever since. “I’ll let Dr. White know you are here. He told me to expect you. By the way,” she added,” Julie Martino wants to know the second you arrive. She is still the Medical Director’s secretary and remembers you warmly.”I’d barely settled into the waiting room when Julie bustled down the hall had gave me a big hug. “Wow, don’t you look great? I was delighted to hear from Lisa that you were coming .  I told her to call me as soon as you arrived. I have been keeping an eye out for you.” Lisa was the receptionist’s name. I smiled back remembering when both she and Julie came to Riggs. Looking at them smiling, I realized they were about my own age. That meant they must have been about my age when they came to Riggs to work. What must it have felt like to work at a place where the patients were your age but came from privileged backgrounds while you were holding down jobs with real responsibilities? Did they see our work as valid?  Just as hard?  What a juxtaposition!Even though I’d forgotten all about Lisa and Julie over the years, as they welcomed me I remembered how all the staff at Riggs had been kind and respectful even when we patients were sullen brats – or worse. I reflected that I’d never been treated as untouchable, or crazy, or as a spoiled rich kid by anyone at Riggs. This element of respect seemed to permeate the secretaries, nurses, grounds people. If Lisa and Julie were any measure, that hadn’t changed. “After you visit Dr. White, stop by and let’s visit.” Julie said. “I want to hear about your life and what has happened. ” She smiled and said, “I’d better get back.”

Lisa announced that I could go up and see Dr. White. The walk upstairs felt as familiar as walking through my beloved childhood house. The floor tiles, the treads on the stairs, the doorways all felt imprinted on my unconscious so that each detail became an entry into my memories. Dr. White’s door stood open to the same office he had occupied for over 40 years. In the old days, whenever I saw his office it was with his patient and my best friend, Bea. Back then, it had been very neat, but now books were piled up everywhere. On his desk was a computer.  Since I’d just got one I was impressed that Dr. White, who was no spring chicken, had taken up this new technology.

Dr. Ess White Photo by Susan Buchholz

Dr. White was soft-spoken with a slight southern accent and rather old fashioned, courtly manners. He always reminded us, although we’d never have said so in front of Bea, of a little white rabbit. He had a fussy manner and  exuded a bit of a mother bunny telling Peter not to go into  farmer McGregor’s garden. Now, all white and rather fragile, the resemblance was striking. Dr. White had always been deeply devoted to Riggs. As he later told me, he moved to Stockbridge in 1951 after doing his residency at Steton Institute and knew right away that he would stay at Riggs as long as they would have him. When they offered him a permanent senior position he took it happily and stayed put through at least four Medical Directors. I figured he was now in his late 70’s.

Dr. White motioned for me to take a seat. He wore designer glasses which seemed too big for his narrow face. His white hair was a touch thin, and he wore a  stylish tweed jacket over a pale yellow tie and a little paunch. A touch of the individual in his dress was a far cry from the formal uniform that all staff wore in the 60’s: dove gray suits with conservative ties and cop-type shoes. Perhaps the notion that the staff had to be clean slates that the patients could project onto had shifted.

Dr. White launched into a conversation as if he’d been talking with me before I even entered his door. “We are trying to develop an endowment. Riggs is in the red and we’ve consulted several professionals who suggested that Riggs needs an alumni organization. That is why your call excited me.” he said, “Perhaps you would be willing to help with a reunion?” He talked about several ideas including one to get James Taylor to play a concert. “What do you think?”

Disappointed that he hadn’t asked me anything about my life, I found myself struggling to pay attention to him. I told myself I wasn’t here for my ego and pulled myself together so I could pay attention. The subtext, as I understood it, was that he wanted ex-patients to help raise money. Raising money, a very worthwhile enterprise, did, however, seem to me to be taboo since Riggs would be asking ex-patients for financial support. I’d always thought there was an ethical rule about not asking ex-patients to support either an individual therapist or an institution. And wasn’t it accepted that the hospital should never use personal and private information (like who had money and who didn’t) to further the hospital’s goals? Was I wrong? And why did it matter to me? Ray and  I talked it over and he agreed that this was an issue of patient boundaries. Another mental detour: I thought about an affair I’d had with an ex-therapist, someone who had been connected to Riggs. Obviously the affair ended  with me holding the secret as a way to protect the therapist. That experience made me very sensitive to the idea of power inequality.

Dr. Robert Knight Portrait by Norman Rockwell

On the other hand, the Riggs of Dr. White and Dr. Knight, who had been the medical director while I was there, had always been my gold standard of ethical behavior. And wasn’t I here to put my past thinking together with the present? As I listened to Dr. White, I intuited that the problem Riggs was having was that the hospital could not contact ex-patients. Patients and ex-patients could contact Riggs and each other, but their privacy was always to be honored by the hospital. So, building an endowment would be difficult without putting an alumni association together. Once an association was in place, ex-patients could be contacted by other ex-patients.

Since the hospital had changed my life, why was I feeling such reluctance to Dr. White’s suggestion? I knew Riggs in the 1960’s had made many mistakes but wasn’t that because of the limitations of the times? Besides drugs and alcohol, what had anyone known about gender issues and homosexuality? These issues had been limitations of the culture and of Riggs.

All these thoughts were buzzing around as Dr. White continued, “Riggs is getting ready for its 75th anniversary”, he said.  “Perhaps you’d help us organize a reunion? You were always so involved in the community and were a leader in it for several years. You would be invaluable.”

I didn’t know what to say. That last comment sounded a little manipulative and I assumed Dr. White  had a mission. I decided it was time to tell him that I was hesitant about raising money. I told him about the carcinoid tumor and of my letting the doctors define my experience instead of acting on what I knew to be true about my own body. Then I told him about an affair with an ex- therapist, whom I knew he knew.

“I understand.” Dr White said, “There are ethical issues and there are some people here who aren’t as interested in protecting these ethics as I am. For instance, discussing patients, even when they are dead and it is legally alright, distresses me. Even case histories where patients’ identities are disguised, bothers me. On the other hand I think we would be a much poorer place of we didn’t have Young Man Luther. Erik’s (Erickson’s ) book was written largely as a result of his work with a young man here at Riggs whom I knew very well. He knew he was in the book. I feel less strongly about it if a patient is fully aware, but I still have a problem with conformed consent. That is the same problem with Riggs fund-raising and asking ex-patients for donations. I really don’t have a problem with ex-patients wanting to help Riggs. What I do have a problem with is when someone is in some kind of subjugation without realizing it and therefore when we ask , are we exploiting? From our side we aren’t exploiting but it is a very difficult issue. Of course to us on the staff this is all a burning issue since Managed Care has threatened the ability of a place like Riggs to exist. When is it ethical for us to participate at all? Can a patient ever be anything else?

“We are discussing the relationship between therapist and patient. Like fund raising or sexual relationships you have to keep a boundary. Power goes both ways. Where doctors and patients have affairs it wouldn’t surprise me to learn that the patient was very seductive. But you see that is the whole reason we have to keep a boundary. Because if we don’t keep a boundary against the seductions of patients, sexual and otherwise, then we can’t maintain that position where we can hear, more or less impartially, what’s being said. If you just join the dance, you’re lost.”

I couldn’t believe my ears. How classic to say that in matters where patients and therapists had affairs, it wouldn’t surprise him that the patient was seductive. Well, duh! Of course the patient will try and give the therapist what they want! That is why asking for sex or money is unfair. Patients do have a sense of wanting to please or they have a sense that Riggs did a great deal and that we owe them. The whole dilemma now triggered  the memory of the summer right before I went to Riggs. I was going to Columbia Summer School so I could stay in the city and not interrupt the analysis I started the year before while I was  a freshman  at Sarah Lawrence. Before the summer session began, my analyst suggested I go home and find out where my mother was buried and how much money I’d inherited. I returned like a proud retriever carrying my information to the waiting master. I was excited by his suggestion because I thought it was very appropriate. So when he responded to my news by saying, “Hmm… now that I see how much money you have, we will need to raise your fees.”  I couldn’t believe my ears. All the safety of his office evaporated. His main concern was his own welfare, not mine. Had I had a safe place to regroup perhaps his suggestion wouldn’t have seemed like such a complete betrayal but as the summer progressed my analysis went to hell and the rest of the summer’s events finally unhinged me.

The boundaries are there to protect the patient – not the doctor.

Well, I was here not to argue but to try and learn so I went on and said to Ess White, “Part of the reason I am here is to rediscover Riggs, not as I imagined it, but as it really was and is. I have so idealized my years here that I’m not sure what the truth was or is. And all of that affects my own definition of myself.”  Then I said, “This seems to be a time when I want to make sense of my experiences. So I am thinking about writing a book about my time at Riggs and I actually came up here to ask if you’d let me interview you. Will you help?” And that was his opening. With a twinkle in his eye he said, “I’ll help you, if you help me.

Advertisements

1 Comment »

  1. I think this page is fascinating, in that it reveals an explores the ethical dimensions in psychological work. You would have to say that the profession has boundary problems, borderline problems.

    Comment by Ray Walker — December 18, 2009 @ 4:41 pm


RSS feed for comments on this post. TrackBack URI

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Create a free website or blog at WordPress.com.

%d bloggers like this: