I am a firm believer in talk therapy — the old-fashioned kind that used to take time, cost money, and almost doesn’t exist any more because pharmaceuticals produce quicker “fixes” and insurance companies therefore like them better. To hear aging psychiatrists tell it, medical school psychiatry these days is accordingly mainly about prescription drugs for the psychotic, which means that M.D.’s are no longer properly trained to hear out the merely neurotic, on couch or chair, for as long as it takes. They leave that to the social workers, a different category of “service provider” entirely.
But in the old days, the right therapist, M.D. or no, could save your life. In some instances literally save it, more often save it metaphorically –by asking the right questions and steering you gently in the right direction, without saying too much, if anything, but devoting all his or her attention to you. That was key — it was always all about you. The other person in the room had no needs, no agenda, for the fifty minutes you spent together. But you did have to find the right one — the one who could listen to you. It took me a while to find that right therapist, the one where the transference took.
In March 1953, I was 21 and knee-deep in several unsatisfactory situations:
(1) First serious boyfriend and I had broken up.
(2) I had allowed my parents to move me out West with them after college because I had no idea of how to look for a job that would support me back East.
(c) After several abortive tries, I had finally found employment, paying $140 a month, in the typing pool at ABC television in Los Angeles. Here I typed sit-com scripts, written by better-paid people, on purple stencils until 4:30 in the afternoon and then joined other pool members in assembling the pages — leaving at the end of each day with purple fingers and thumbs that required a lot of soap to come clean again. Me, the college graduate! A young woman in Personnel not much older than I had promised when something better opened up, it would be mine. I soon realized she had lied.
(d) As for the new man in the West who had somewhat replaced first serious boyfriend in my affections — he was nine years older, had four small children by a previous marriage, was paying alimony as well as child support and, as a university instructor, earned what my father scornfully termed “bubkes.” He was also not Jewish, which didn’t go down so well at home, either. Not that we were observant, or that he ever went to church. It was the principle of the thing.
In short, I was not a happy camper. One morning, as I was about to pass reluctantly through the ABC front gates, I found I just couldn’t. Spinning around, I went back to the ’37 Plymouth coupe the divorced man had helped me buy, drove to his studio apartment, knowing he would be at work, and used the key he had given me. I needed help. First serious boyfriend — still on my mind — had found it with a therapist. (For which his parents had paid through the nose.) Maybe I should try a therapist too, even though my parents thought therapy was for “crazies.” I looked up the number of the L.A. Free Clinic for Mental Health in the divorced man’s phone book, used his black rotary phone to call, and obtained a clinic appointment.
I had to wait three weeks. Stoically, I endured life until then.
The address I’d been given over the phone was near Chinatown. The lobby of the clinic was a stew of sour unhappiness: crippled and misshapen people, troubled-looking people, in some cases malodorous — all milling about and obstructing the way to the front desk. Children cried. A mongrel dog with scabrous ears had lost its owner and trailed a broken leash around unfamiliar feet, whimpering.
After a ten-minute wait sandwiched between other people’s thick thighs on a crowded bench, my last name was called and I was assigned a seat in a small glassed-in cubicle off the lobby, equipped with rickety plywood desk and Underwood typewriter.
Another ten minutes went by. At last, a blank-faced older woman in a tight rayon print dress sat down heavily opposite me and proceeded to ask a seemingly endless series of tedious questions, the answers to which she laboriously block-printed on the form in front of her: First name, middle name, family name (that one she asked how to spell), address, telephone if any, schools attended, years of school attendance, highest year of education completed. The “middle name” part of the questionnaire gave trouble. I didn’t have one.
“I have to put one down,” said the woman.
“There isn’t one on my birth certificate,” I said.
“That doesn’t mean you haven’t got one. I need a middle name.”
We stared at each other. Impasse. “If I had been born in Russia,” I finally said, “it would have been ‘Mikhailovna.'” This was true.
“Were you born in Russia?” she asked.
“I can’t leave a blank. Can I put it anyway?”
I sighed. No one had ever called me “Nina Mikhailovna.” But she was chewing up precious time. [I still assumed I would be speaking with a professional after these preliminaries.] Besides, does anyone really look at these things?
“Put it anyway.” I spelled it for her.
Then we continued: current place of employment, position, how long there, salary, previous place of employment, position, how long there, salary, reason for leaving, nearest relative, relative’s name address phone if any… God, she was slow! What good was the Underwood if she wasn’t going to use it?
“Problem?” the woman asked.
“Your problem. Why are you here?”
“I’ll tell the doctor when I see him.”
“I have to put something.”
“Put ‘personal.’ ”
The woman looked at me impassively.
“Family issues, all right?”
The woman carefully printed “Behav. Hlth — Fam. Iss” on the last line of the form. Done at last! She consulted another paper under her pad of forms, her finger running down a column of figures. “$5 a visit.” I nodded, thinking of the $45 first serious boyfriend’s parents had paid his therapist.
“Sign here,” said the woman.
“Next Tuesday, 5:30. Room 110,” said the woman, getting up.
“But what about today?” I cried. “I have a crisis. I came for help!”
“No help today. You don’t want to come Tuesday, 5:30?”
I capitulated. “I’ll come.”
Room 110, when I reached it the following Tuesday, looked like my eighth grade classroom at P.S. 99 Queens. I squeezed myself into one of the little pupil seats with an arm on which to write, and waited. After a while, a young woman wearing a green sweater came in with another typed questionnaire; this one had blanks after some of the questions and boxes to check off for the questions that were multiple choice. The first page was headed, “Los Angeles Free Clinic: Behavioral Health Division.”
I had to use my own pen. The young woman sat with crossed legs on a stool at the front of the room and began to read a book. No one else was there. Why did I need a proctor? Did they think I was going to cheat on the answers? I peeked at the bottom of the last page; there were 203 questions. “Don’t jump around,” directed the young woman, looking up. “Start at the beginning and keep going. If you don’t finish, that’s all right.”
It was now a month since my desperate phone call. I worked my way impatiently through the first couple of pages — inquiries into full name (all three again), nickname, date of birth, names of family members, pets, friends. Then medical history, educational history, work history. (Come on already.) Did I believe in hell? Heaven? God? Best thing about myself? Worst thing? Favorite food? Favorite activity? Vindictively, I wrote, “Fucking.” (The divorced man’s word. I myself always thought of it as “making love.”) What would I do if I found out my best friend was lying to me? Stealing from me? Having an affair with my husband/wife [choose one]?
“Why am I filling this out?” I asked the young woman in the green sweater. “I just want to talk to somebody. Why can’t I talk to somebody?”
The young woman looked up from her book, annoyed. “It’s diagnostic,” she said. “You don’t get to talk to anyone till you’ve completed the diagnostic.”
I’ll give you diagnostic, I thought. I drew a diagonal through the rest of the questions. “Done!” I announced. “Now can I see someone?”
“Next time,” said the young woman. “Make an appointment at the front desk for next time.”
“Next time” was not for another two weeks. “But I’m in crisis,” I pleaded at the front desk, without conviction. My month of waiting was inuring me to dull misery.
“Are you suicidal?” asked the man at the desk. “Are you a cutter?”
I hesitated. Was I about to destroy myself because of the divorced man or the job? What was a cutter? “I guess not,” I said.
“Two weeks,” said the man.
On the first of May, I paid five dollars at the front desk and finally saw a doctor. “Nina Mikhailovna?” asked a tall thin young man in a white coat with a look of determined cheer on his face. He had said “Mikhailovna” correctly. He must have studied up on me for for this meeting, perhaps consulted a Russian speaker on fine points of Russian pronunciation. Then he strode confidently into the small room where I had been told to wait. “I’m Dr. Frug, Jonathan Frug. Your treatment supervisor.” He held out one hand for me to shake; I could see he had my so-called “diagnostic” in the other. He looked no older than first serious boyfriend. Was I supposed to bare my soul to someone only a few years older than I was? He must be an intern. Or a resident.
“Nina,” I said. “My name’s Nina.” I waited until he had seated himself at another of the Los Angeles Free Clinic’s plywood desks. “You see, I have this boyfriend. He’s divorced? With four children? And I seem to be stuck. So I need help.”
“Well, we’ll get to that,” said young Dr. Frug kindly. “But first tell me, Nina Mikhailovna…. You have such a lovely name. Why don’t you like it?”
“I don’t have anything against it. It’s just not my name. Everyone’s always called me Nina. All my life.”
“But you put down that Nina Mikhailovna is your name. Here, on the first line of your questionnaire. And again on your diagnostic. Now you tell me it’s not?”
I sighed. “Dr. Frug. The intake woman insisted that I had to have a middle name.”
“So you made one up? To please her?”
“Not exactly. If I had been born in Russia? Everyone there has a patronymic? You know, a middle name based on the father’s first name? And that woman was so insistent?”
Why was he putting me on the defensive before we began? Why was my every sentence turning into a question?
Dr. Frug took careful notes.
I continued, consciously declarative: “Mikhailovna is not on my birth certificate. Or social security card. Honestly, Dr. Frug, you’re making too much of this.”
Dr. Frug shook his head indulgently. “We’ll see,” he said. “What do you think of when you hear the name Nina Mikhailovna?”
“I think of an unhappy late nineteenth-century Russian woman. In a Chekhov play. They all had those double names.”
He looked at me sympathetically.
“She’s probably not the heroine,” I babbled on in the silence. “She has braids.” More silence. “My mother always liked Chekhov. He’s a Russian playwright.”
At last he spoke: “And is that your heritage? Are your people Russian?”
My “people?” My mother and father were non-observant Jews. “Not really,” I said. “My parents are naturalized Americans.”
Dr. Frug took more notes. “And how do you see yourself?” he asked presently.
“Me? I was born here,” I said. “In New York. After they escaped from the Soviet Union.”
Dr. Frug sat back and looked at me in a friendly manner. “So. How does it make you feel to say your name isn’t really Nina Mikhailovna, a name so rich in cultural signifiers?”
“Do you really want to know?
“Yes, I do,” said Dr. Frug.
“It make me feel very annoyed with you, Dr. Frug, for frittering away my time this way.”
“I suggest you’re rejecting your identity and that annoys you?”
“That’s a ‘how often do you beat your wife’ question, Dr. Frug. But yes, yes it does.”
He didn’t miss a beat. “How does it feel to say you feel annoyed?” he asked.
Trapped. I was trapped in a parallel universe with young Dr. Frug.
We never reached the “favorite activity” part of the questionnaire. Dr. Frug had just come to the “Do you believe in God?” question when we ran out of time.
I never went back. The next week, the divorced man found me a better job as a trainee copywriter in the advertising department of The Broadway Department Store. The hours were 9:00 to 6:00 (with an hour for lunch), and I couldn’t easily work Dr. Frug into that schedule even if I had wanted to, which I didn’t. In fact, I wouldn’t have gone back under any circumstances.
However, I did receive a letter from him nearly three years later, when I was about to marry the divorced man. The letter expressed concern for my well-being and an invitation to call the clinic to resume “treatment.” Young Dr. Frug didn’t fool me, though. If he had really felt concern, I would have heard from him long before. He was probably closing his files at the end of his internship. Or residency.
Perhaps it goes without saying that the marriage was a mistake. Although I doubt Dr. Frug would have known that, even if we had continued together. But of course we didn’t.
It would be another five years before I found the right therapist. Actually my husband (the previously divorced man) found him for me. By then, I had misspent most of my twenties in turmoil and angst. But I now had another job, with an okay salary, and the therapist was generous in adjusting his sliding scale quite far down for me.
With his help, I at last began to turn my life around for the better.
4 thoughts on “MY FIRST TIME”
I believe in talking as well, though if I want to see my doctor I have to wait three weeks unless it is an emergency. Also, you are supposed to only talk about one problem. I go so rarely I take a list. Ha Ha. I talk to friends until I hear a note of boredom creeping in.
Friends are of some help. But they really have a dog in the race. You may think when you talk to them that it’s all about you and your problem. However, in my experience, even the most well-meaning friend is driven by an agenda, perhaps unconscious. Which is why I prefer to keep the deepest, knottiest problems for a professional, hopefully older than I am. Unfortunately, older than I am is getting hard to find! 🙂
How do you feel about Clinical Psychologists? I think you’re so right in that psychiatrists now deal mostly with medications. I think also that there was a split sometime in the 1970’s or 1980’s where psychiatry really changed. Then the ‘clinical psychologists’ came into the scene and there was this notion that the psychiatrist would medicate you; but the “psychologist’ would be the one who would really “talk with you”. I think it began to change for the better in the 1990’s, but the Phd’s in Clinical Psychology are still going very strong, or at least seem to be.
I have no views on or expertise about the history of treatment modalities, other than to note that what you call a “split” was driven by the requirements of the insurance companies paying for the treatment. I also cannot offer anyone an opinion about therapist training and credentialing other than to emphasize that the most important element in a successful therapy is not the title of the therapist but the length of practical experience the therapist brings to the treatment, the empathy between therapist and patient, and the willingness of the patient to work at it.