I’ve dealt with drastic mood swings since I was about 14, later diagnosed as manic depression, later renamed bi-polar disorder; but more commonly known by the layman as bat-shit crazy.
I could write 1,000 posts on just that alone. How I’ve lost friends and won awards, felt suicidal and felt invincible, been unable to get out of bed and accomplished amazing feats all within the same week. However, that’s not particularly pertinent to the incident about which I am now writing. I’m only telling you that so you can read this post in context with my general state of mind on any given day.
Although ongoing, consistent treatment is the best way to manage my condition, anyone who suffers understands that when you’re manic, you’re perfect. You can do anything, accomplish anything. You don’t need anyone’s help or empathy. Their opinion of you and what you’re doing is completely irrelevant. You’re on a natural high. You're bullet proof. You can do no wrong.
As a result, each time I’d be riding a wave of mania for more than a couple of weeks, I would cease all therapy, refuse all help and in many instances, stop taking all medications. Magically, I would suddenly have a simple resolution to any problem that was plaguing me. I could do everything perfectly on my own. I didn’t need chemicals to make me feel good, I was amazing. I felt great! And I sure as hell didn’t need to pay $85 an hour just to have someone to talk to.
So, my history with therapy is sporadic at best. I think the longest I’ve ever stayed with one therapist, psychologist or psychiatrist is maybe 8-10 weeks. More often than not, I drag myself to the phone at some point during a crash, feeling totally hopeless, and get an immediate appointment with the first organization that doesn’t banish me to a wasteland of endless voicemail menus.
By the time the third or fourth session comes around, I’m feeling great again and the cycle starts over…I can do everything on my own; I don’t need medicine. I don’t need to pay some therapist to pretend to care. I am fucking awesome!
Months would pass until I’d find myself, once again in the fetal position on the floor, reaching for the phone in hopes of finding someone who could save me.
So here I was once again, trying to see if I could get in for a quick round or two of therapy that would allow me to keep my head above water until I was “ok” enough to at least be functional.
I had recently changed jobs which meant new insurance and trying to navigate a whole new system of providers, referrals and co-pays.
In the few months that I’d been a member, Kaiser had been wonderful. But this was the first time I was seeking mental health support and I was discouraged to hear that there were far more unstable people in Los Angeles than I had expected.
My options consisted of waiting over a month for a local appointment, driving approximately a half hour to another city for an appointment in three weeks, or selecting an approved, non-Kaiser provider.
I couldn’t wait, I didn’t know what the next week would bring and I didn’t want to risk falling into an even darker pit. I knew the deeper I fell the longer it would take me to get back to the surface.
So, I opted for the list of resources that were contracted to provide mental health services when Kaiser was maxed out. I scanned the list… too far, bad area, no evening appointments. I finally found a couple that sounded good and called.
“Sorry, we’re not taking new patients.”
“We don’t have anything until October.”
"The doctor is on vacation in Spain and won't be back for six weeks."
I was starting to get teary as I dialed the fourth number on the list. The call was answered by the therapist herself, which I found odd, but refreshing. No voicemail black hole, no promise to get a call back within 72 hours. Just Dina London saying she’d be happy to meet with me the next day at 4 pm.
I arrived at 3:45 because I’m the kind of person who would rather be an hour early than 5 minutes late.
I glanced at the GPS on my phone and double checked the address. I was in front of an old, Victorian style house which needed a paint job and some elbow grease to restore it to its full potential. Still convinced I was at the wrong place, I walked up to the front door.
On the glass window was a series of adhesive letters that spelled out the businesses within. An employment lawyer, an accountant and an acupuncturist were listed. Finally I saw her name in peeling gold stickers. Dina London, followed by a string of letters and designations which were probably important to someone somewhere, but to me meant nothing.
The door opened with a creak and a staircase appeared in front of me. To the right was the door for the acupuncturist. The carpet on the stairs had once been blue and there was a hint of the original color at the edges. But the well-worn center had seen a lifetime of traffic and was almost down to the webbing beneath. I wondered if it was the same carpet that had graced the house when it was occupied by a family.
I could almost picture a typical family from the 1950’s inside, dad smoking a pipe on the nubby, green couch while mom (wearing a dress and heels, of course) danced effortlessly across the black and white checked linoleum floor preparing the meal. On the fresh, blue carpet Jack and Susie fought over crayons as they scribbled in their gender specific color books.
The current house was a sad disappointment in comparison to my imagination and I tried to ignore the chokingly musty air.
At the top of the stairs was a little community area with a small credenza which held literature for all of the businesses on site. A desk was piled high with files and paperwork and I wondered if it belonged to the therapist, the acupuncturist or the lawyer. What kind of confidential information was strewn about so carelessly?
I searched the rest of the room which was completely empty but for a couple of dead plants. Two closed doors were labeled for the therapist and the attorney. In front of Ms. London’s door was a framed note asking patients to take a seat and she would be with them at their scheduled appointment time.
A tiny, former bedroom to the left had been converted into a makeshift waiting room with a loveseat. The rest of the walls were covered with bookshelves that overflowed. Additional piles of books were stacked on the floor all around the room. I edged myself through the maze of literary stalagmites and took a seat.
I’d had enough experience with hoarders that I could tell whoever was in charge of the waiting room was at the top of a steep hill that ended in residing among a pile of cat waste, empty yogurt containers and a collection of Marie Osmond dolls.
At 3:51 I realized that the air upstairs was markedly worse than downstairs. At 3:52 I began to wonder if the smell was that of a decaying body. By 3:54 I was fully convinced that the whole appointment was a set up designed to kidnap me for the purposes of harvesting body parts.
I peeked into the small door in the hall. Yep, it was a bathroom. I searched for signs of blood around the sink and floor. All clear.
I checked the bathtub. It wasn’t filled with ice, which was a good sign. I took a deep breath and
settled back down on the couch.
At 4:04 I heard a door open and Dina London appeared in the waiting room doorway and introduced herself. We went back into her office and did the customary first visit routine. I explained why I had come to see her, what my struggles were and how I was feeling useless and invisible. She wasn’t the worst therapist I’d ever been to, but we didn’t seem to click either.
I’ve always hated conflict, so even if I didn’t like a therapist, I would schedule a second appointment and then call and cancel it the next day. That way I was never in the uncomfortable position of having to divulge why I didn’t plan to return. I knew any explanation would make me sound even more crazy. Not liking a doctor’s goatee, being grossed out by their gum chewing and hating the fact that a therapist said “nucular” instead of nuclear had all been reasons why I had left previous providers. And while those reasons seemed perfectly valid to me, I just wasn’t ready to reveal the depth of my psychosis yet. So, I went ahead and scheduled my second session.
By the time the following Tuesday came around I realized I had forgotten to cancel the appointment. Maybe it was a sign. Maybe God was trying to tell me that I needed to stick with it. That I needed to do something different this time and maybe I’d be successful.
I convinced myself that just because Dina wasn’t seeing patients in a traditional office didn’t mean she wasn’t qualified to help me. I accepted that not seeing anyone else in the entire house didn’t mean she was a quack or serial killer. I embraced the fact that I would just have to breathe through my mouth during the entire visit to avoid being assaulted by the tomb-like air. I was kind of proud of myself. Here I was, feeling my lowest and I was making a good decision. I was choosing a path that was foreign. I was going to stick with it! I was feeling better already.
I inspected the book titles as I waited again on the loveseat for my session time: Still Stripping, Predictably Irrational, The Man who Mistook his Wife for a Hat, The Psychopath Test. It was eerily quiet as I counted the ceiling tiles. Twenty two. I counted the ones with water stains. Fourteen. I wondered how many written words were contained in the room I was sitting in. Could it be a million?
I wonder if there’s a million grains of salt in one of those cardboard Morton’s containers? I have absolutely no concept of what a million of anything would look like.
I wonder how many people would care if I died?
I counted 7. And one of them would care only because I owed him money. I wondered why I hated the word uvula so much. And why I loved the word discombobulate. I was so lost in thought I didn’t hear the door open and suddenly Dina was in the doorway greeting me.
I settled down in the same seat as the week before and she prompted me with a few questions. I confided how a woman ran her cart into me at Target the day before. And how a couple let a door slam right in my face. I lamented about feeling invisible, being insignificant. I felt worthless, had no self-esteem and wondered if people even noticed when I was in the room.
“It’s as if I don’t exist. Nobody cares. I mean, I’m not even likable enough to have a friend to talk to! I am here paying someone to listen to me!”
The tears flowed as I reached for a tissue. I looked at Dina for some empathy and understanding, or at the very least, some suggestions. Her eyes were closed. I waited a few seconds thinking maybe she was deep in thought as to how to help me. She didn’t move.
My blood began to boil. Seriously? Asleep? I’m here trying to find a reason to live and this stupid bitch is asleep? If I had any balls at all, I would have stood up and slapped her.
“What the hell is wrong with you”, I’d yell. “What kind of professional, counseling a person with self-esteem and worthiness issues, falls asleep? You’ve got some nerve! I will be sending you a bill for my time! What do you think about that?” Then I would get up and spit in her face and degrade her mother. Ok, so maybe that’s a bit extreme, but you get the idea.
So, being a person who hates confrontation or anything that could possibly make anyone feel bad, I took the passive aggressive approach and spoke louder. I figured when I spoke louder, she would wake up and be embarrassed. She would immediately apologize and explain that her newborn had been in the ER the night before, or she had been up all night comforting a domestic abuse victim. She didn’t.
Her eyes slowly opened and I continued to talk. She would occasionally punctuate her micro-naps with active listening by uttering a “Hmmm” or an “I see”. Throughout the rest of the session, she continued to close her eyes and drift in and out of sleep.
I would raise my voice a little bit each time it happened. I’m pretty sure that by the end of the session I was loud enough to be heard by everyone else in the building, had anyone been there.
I wrapped the session up early by lying and saying I had somewhere to be. I was angry and humiliated; but I still didn’t want to be rude or hurt her feelings. Besides, it was probably my fault for being so mind-numbingly boring. So when she asked about an appointment for the following week, I made the excuse that I had some commitments and I would need to check my calendar before nailing down an exact date.
I got out of the door as quickly as I could and climbed into my car and sobbed. The track running through my head was on a continuous loop. I can’t even pay someone to care about what I say or do. I really am invisible. I am so humiliated!
I had only driven about 5 minutes when my phone rang. The display showed the name London, D. I just couldn’t. I knew she was calling to apologize, but I was so unbelievably embarrassed. She was probably feeling sorry for me because I was so dull she couldn’t even listen to me for more than 10 minutes without drifting off. I didn’t have the strength at that moment to relive the humiliation. The call went to voicemail.
By the time I pulled into my driveway, I had stopped crying, but my eyes were swollen and red. I put the car in park and grabbed the phone. One voicemail.
“Miss Carter,” the voice said. I held my breath and waited for a flood of apologies. “I forgot to get your co-pay, could you stop by tomorrow and pay your $10?”
I could literally feel the blood pressure increase in my veins. Really? That’s what she called about? After her appallingly unprofessional actions, she has the nerve to contact me about $10 that she forgot to ask for? I knew she was going to get $75 from Kaiser for the visit, so I deleted the message and hung up trying to avoid the imminent stroke-inducing aneurysm I could feel building.
Over the next several weeks she called three more times asking for the $10 co-pay. Her final message was curt as she said that she had provided me with professional services and I was obligated to pay her. As her words sunk in, I dialed her number and let loose. She wasn’t able to get a word in edgewise.
“Professional services? You provided professional services? I came in with self-esteem issues and told you I felt unimportant and invisible and you promptly fell asleep! Not once! Not twice! But several times! And you know what I did? I didn't want to point out your incompetence by saying anything, so I just kept talking louder to wake you up! It was horrible. I felt worse when I left than I did when I went in! Then, to top it off you call me multiple times, not with an apology, but with a demand for $10 for the services you didn’t provide!" I should have hung up there, but the fifth grader in me came out. "And your office is gross!” I yelled and hung up.
I went directly to my computer and vented about the entire ordeal on Yelp, pointing out that it was clear she was horrible at her job if $10 in unpaid fees was going to break her. I submitted the review for posting and took a deep breath.
As I scrolled through the other comments, I found an account from another patient who had a similar experience. As sad as it was, I got some solace from knowing I wasn't alone. I felt a strange kinship with the other poor soul who had bored Dina to slumber. We messaged each other back and forth a few times and commiserated about our shared indignity.
A few days later I received a response from Ms. London via Yelp stating that she hadn’t ever fallen asleep on any patient and she was simply drowsy because she had a busy life and many obligations. (Translation: Look, loser, my life is full of all kinds of great things, which you can’t even conceive of. Perhaps if you hadn’t been so bland and colorless, you may have kept me awake. But, let’s be honest, you’d have to pay me double to sit and pretend like I care about anything you have to say.) She followed up with a statement that my assessment and review of her was “unfair”.
That was about 2 years ago, and the last time I went to therapy.
About two months after the incident I stopped by a local Starbucks and immediately recognized my nemesis sitting alone in the corner working on her laptop. I was tempted to go up and sarcastically ask if she could no longer afford her fancy, upscale office. Or question how many of her patients she had ushered to suicide in the past month. Maybe even congratulate her for remaining awake long enough to drink a cup of coffee. But I took the high road and went straight to the counter to place my order.
The barista joked about my drink and asked what I had planned for the day.
There was no one behind me, so we spoke for two or three minutes. I’m not stupid, I knew she got paid for making customers feel valued. But she did a good job. She made me smile. She made me feel special. She made me feel like she cared.
As we wrapped up our small talk, I pulled a $10 bill from my wallet, put it in the tip jar and said (a little too loudly) "Here’s my $10 co-pay for the therapy session." She looked confused. I took my drink and turned to leave. Out of the corner of my eye, I saw Dina look up at me. I walked out the door and I could feel the swell of mania building up in my chest. “It’s gonna be a great day! I’m fucking awesome!”
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