Monday, November 18, 2013

The Disparity Between The Therapist and I

After Thomas' session the other day I went in to talk to his therapist alone about the fact that my dad is dying and I was concerned how Thomas would take that when he was finally told. I told him that, as his therapist, he needed to keep an eye out for depression and any other thing that might manifest once Thomas knows. He became concerned and asked a few questions but then seemed to jump to another topic without fully giving thought to what I had just said and the toll it might take on Thomas.

There he stood, telling me how terrific Thomas is doing and that he felt that this had been the best Thomas has been since this time last year. While I do agree with him to some degree, I couldn't help but think back to my earlier conversation with Thomas about his delusions. All I could see was that Thomas is still locked in tightly with his beliefs and those seemed unchanged.

This has happened a thousand times before. His therapist isn't privy to the information that I am so he sees a much brighter picture than I do. Sometimes I feel like he gets some kind of commission based on how well HE thinks Thomas is doing and that frustrates me. I told him a little about what Thomas had told me and he all but waved me off and said.

"Well, if he starts not showering or something then we need to be concerned."

There it was. The measuring stick, according to the therapist, that Thomas isn't in a good place. It's funny because there is so much that I just live with now that I don't think to bring these things up. Thomas hadn't been showering and he and I have had our typical struggles over that but I hadn't thought to bring that up to his therapist because that's just how it is. That is what Thomas does sometimes. When I told him that Thomas was showering maybe twice a week, if that, he stopped in his tracks. Finally he was going to listen. He didn't like that at all and wrote that down in Thomas' chart. So much for his commission.

I went on to tell him that Thomas seems disconnected from the rules of being social because he had shaved the other night without shaving cream 20 minutes before work and was bleeding horribly and I had offered him a styptic pencil to stop the bleeding. The thing is, the styptic pencil leaves behind a white film that is very noticeable and he looked like he had grown a snow white mustache. I told him to dab at the remains and try to get it off and he came out of the bathroom a little cleaner but still with a white upper lip. He was ready to go to work.

I kind of let it go to see what he was going to do and he seemed unmoved by the fact that he was about to enter the work place looking like he did. All of the anxieties he has about working are there but this, this showing up with a white upper lip, didn't seem to phase him in the least. I told him as he got out of the car to go straight to the bathroom to finish cleaning up. When he got in the car that night he was clean but I was left wondering about the bigger picture. Why does he not care about showing up with a white upper lip? Why did he shave 20 minutes before work with a dull razor and no shaving cream and why had he not showered in a few days?

This is not the picture of a healthy kid and I let his therapist know all of that. Strangely I left out the whole mess about Thomas thinking that the government is coming into his room and all of the other stuff because the glow emanating from his therapist about his GREAT SUCCESS with Thomas was fading after telling him about the showering and the shaving incident and somehow I didn't have the heart to take away his pride.

So, why is there this disparity between what the therapist sees and what I see? I think it's because for time eternal he thought Thomas had "just depression" or "just prodromal bipolar illness" all while everything about Thomas, all of the psychotic breaks, all of the delusions lay locked up inside of him and after all of the years that Thomas spent with this man he hadn't known these things about Thomas. It was me that told him then and it's me now that reminds that bright shiny therapist that things just aren't always as they seem. The picture painted by Thomas in therapy is far from the true work of art stored inside his mind and what manifests at home.

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