Wednesday, December 12, 2007

You Crushed My Foot You Big Oaf

A Psychiatric Parable
By Patricia Lefave, Labelled, D.D.(P)

Once upon a time there was a lovely older woman whose turkey neck was not yet in full development, who had been staying within her own personal boundaries, minding her own business, when along came a strange man (and I DO mean strange) who decided he was going to have him some oafish fun conning this woman about himself. He considered her to be ‘stupid’ because she wasn’t ‘friendly’ like all the other gals around and because she tended to assume people like him were sane until proven otherwise. He thought this assumption very foolish so he decided she deserved just what he was intending to give her for being such a fool.


So, he set her up to appear to be a moron or a crazy woman in the eyes, and very noisy opinions, of everyone else. Then he watched her and everyone else as they tried to make sense out of what was senseless right from the start. He especially enjoyed watching her as the victim though, and the distress he caused as she tried to explain her point of view to all of those he had manipulated to believe was something quite different. The harder she tried, the more ‘amused’ or abusive the mob involved tended to become.


Eventually, under tremendous pressure, and the non stop invalidation of her thoughts, feelings and experience of the event, the woman broke and the strange man who had set her up for the attack, smiled with great satisfaction. The woman tried to tell the other people that this strange man had caused this and that he was clearly pleased about the outcome. Of course, they did not believe her, since the strange man had led her away from the truth right from the start. Besides, the reasoned, it would not be reasonable for someone like the strange man to DO such a thing.


Instead, since SHE was the one who was upset and since no one else in the mob of observers could see anything wrong with the strange man, (only she saw that. He seemed like a really decent guy to them) they all decided, by group consensus, that she needed to se a psychiatrist for an assessment. They just ‘knew’ she was ‘mentally ill’ since she claimed to have been ‘set up’ (Diagnostic Trigger Words) was being ‘watched and followed’ (DTW) and was being ‘abused’ by a ‘mob of people’ she ‘didn’t even know.’ (DTW)

Why would people she didn’t even know behave that way? It made no sense. Therefore, it could not be true. If it wasn’t true, then clearly, an alternate explanation needed to be found. So they found one that fit their needs: ‘mental illness,’ a ‘perception/reaction’ problem in the complainant. By defining it this way, everyone else involved could see him or herself as ‘outside’ the problem which was now neatly contained within the semantics of the definition.
Soon, staff members from the local psychiatric hospital began following the woman around, just to keep an eye on her, in case she might decide to do something the others did not like or understand. Local bus drivers began noting all of her movements and reporting to all of their friends and relatives on staff at the psychiatric hospital and visa versa but, this had to be done in ‘secret’ of course, since it would be against the rules of ‘CON-fidentiality’ to discuss this with any ‘outsiders.’ None of them noticed the split in reality they were creating at the nexus of meaning. They were too busy ‘following her and reporting on her’ (DTW) because she ‘thought’ (DTW) she was being followed and reported on. She ‘thought’ they were helping the strange man who had ‘set her up’ (DTW) to get to her, even in her own home. She had started to feel there ‘was no safe place for her’ (DTW) since no one would listen to her, take her seriously or give her any concrete help (DTW) with her real problem. As far as they were concerned, there was no ‘real’ problem since they did not see it and they believed themselves to be well ‘hidden’ in plain sight, from an ‘inferior’ who was not as ‘sane’ as they were.

One day, as she was leaving her home, feeling more and more threatened and unsure of herself, and confused about what was actually going on, a psychiatrist pulled into the driveway, very casually, just to ‘chat’ with her. He asked her what she ‘thought’ the problem was. (He was sure she had one of those ‘brain diseases’ that cause people to ‘think’ they have problems they really don’t have.) Being na├»ve and a rookie with psychiatrists, she actually TOLD him. He the indicated to her very plainly that he did not believe her. At that moment she knew she was trapped in the mirror. He was reflecting on a reversed image of her and he had all the power. Her fear began to grow. The psychiatrist saw it on her face and ‘interpreted’ it to be part of her ‘illness’ from which he was now positive she ‘suffered.’ (DTW)
‘I am going to get you the help you need,’ he informed her; now certain he was the messiah of her troubled life. I will back out onto the road and you can get into the van and I will take you right to the psychiatric hospital for ‘treatment.’ He then backed up over her foot and crushed it.

She screamed with the agony of de-feet!


He ‘interpreted’ that as hysteria. ‘No need to make so much noise,’ he told her. You don’t want to disturb your neighbours do you?”
“I don’t care about my neighbours,’ she squealed. ‘I am in agony.’
The psychiatrist was very concerned about the woman’s lack of concern for her neighbours but then that was so common in these poor sick people. They all had boundary problems you know. She was also now exaggerating her pain as they so often did just to seek attention.
‘I know it hurts,’ he told her, ‘but there is no reason to exaggerate the pain.’
I am not exaggerating, she told him, ‘you aren’t the one feeling my pain so how do you know how much it is.
‘We all have pain in life, ‘he told her believing everything was an abstraction or a metaphor, ‘we must learn to live with it.’
This confused the woman. ‘Why do I need to learn to live with it’? she asked him. ‘I want to go to the hospital and have my foot looked at right away.’
‘What does this have to do with your foot’?
‘You ran over it. You crushed my foot you big oaf!’ she yelled at him.

The psychiatrist wondered why she was accusing him of doing her harm. Perhaps he reasoned, she had trouble accepting authority. He tried to distract her saying, well I am sure you think your foot hurts and I believe that you believe that too, but for now, let’s just go to the psychiatric hospital and get you a little something to help you calm down. You have to admit your voice is kind of high and strained and you are feeling quite upset.
She did have to admit to that so that was a point of agreement at least. She decided to humour him and go with him to swallow a tranquilizer if it would get her the help she really needed. He decided to humour about her ‘foot pain’ if it would get her the help she obviously needed but was resisting and denying. That was the beginning of a long and arduous journey for this woman who was destined to spend an enormous amount of time, with an endlessly aching foot, trying to break the psychiatrist’s resistance to hearing her, and attempting to get him to just accept what she was saying at face value. Of course, later on she would learn that psychiatrists are trained NOT to accept anything at face value which the people THEY have designated as patients say to them. Had she known all of this from the beginning it would have greatly lessened all the confusion she was going to face, but at the time, she had no idea how crazy was the thinking and reasoning of psychiatry itself. Things got so crazy that eventually she broke down completely at which point all the people who had followed her and diagnosed her from the start felt justified about their beliefs, judgements and behaviours. It was a self fulfilling prophecy but none of them would realize that until decades later.

When she finally escaped from psychiatry, she went back to the general hospital where she had told them the psychiatrist had run over her foot and asked them to look at it as it was now causing her a great deal more pain than it had before.
The attending on duty then decided to take an X-ray to see if anything was going on in there and there he saw a mess that had healed without any treatment and was all out of alignment.
He went back to tell the woman the cause of her pain.
The X-ray shows that you had a compound fracture of your foot at some point that was never set properly. ‘Why did you not get that looked at, at the time when it happened?’ he asked her.
‘I tried, ‘she told him, ‘but no one would believe what had happened.’
‘What happened,’ he asked her.
‘A psychiatrist backed his van over my foot.’
‘You don’t expect me to believe that do you?, he asked her.
She had long ago stopped expecting that. Time had taught her well. ‘No,’ she said, ‘if you don’t believe that, than I don’t expect you to and I don’t think any amount of explaining it will change that.’
The attending decided to check her history as she seemed to be trying to reverse things on him and discovered she had a psychiatric history and once had complained of being injured by a psychiatrist. Some delusions are so entrenched, he thought to himself, that there is no point in trying to discuss them with the patient, so he went back out and told her, ‘Well whatever it was that happened to your foot, it does need some attending to now.’
‘So you don’t believe me, right’? she asked.
‘Well’, he said, ‘I believe that YOU believe it.’

(The statement, “I believe that YOU believe it” is psychiatrese for, “I don’t believe you.” )
As she left the hospital, clutching an appointment card to see a surgeon arranged by the attending, she saw her old psychiatrist backing out of the space in front of the psychiatric hospital, (which was across the street from the General) and right over a garbage can.
‘That garbage can could have been my foot you big oaf!” she yelled across at him.
He just smiled condescendingly. He also knew there were some people who had such firmly entrenched delusions that there was no way you could talk them out of them since in truth, reason had nothing to do with it.

The woman actually knew the same thing but of course neither the psychiatrist nor the emergency room attending had any idea that she knew the same thing that they knew. They understood that she was genetically different to them and so words did not mean the same thing to her as they did to them. They both lived in the alternate reality of their own invention and she could not get them out of it no matter how hard she tried or for how long she kept up the effort. She decided she was going to have to leave them there until hopefully, it would one day dawn of them, that the whole relationship was nothing but an extravagant illusion based on an extremely elegant CON.

If it wasn’t for the pain they were causing her and to others, she might even feel kind of sorry for them.


Moral:
When you run over my foot with your van, my foot is just as crushed and the pain just as real, whether you accept it or not, and also whether or not you deny that you did it, or don’t believe that you did it, when you are told about it, or were unaware that you did that.

If you don’t accept even evidence of that, or refuse to look at the evidence (mashed foot under your wheel, X-rays, blood etc.) because you don’t want to be responsible (get blamed) you are them responsible for adding MORE damage to that which you have already done. So I might just respond to that in psychiatrese this way: For some of you, “I believe, that you don’t believe, that you actually do harm.’ (picture a condescending little smile with that; a sort of attitudinal pat on your little pointed head.)
If you then spend years, or decades, denying what you have done and/or justifying yourself, then blame the patient for expecting integrity from you for ‘too long’, then perhaps you should seek some professional help. Try a psychologist who has NOT been trained by psychiatry and who perhaps may be able to help you reconnect to the reality of living in the world instead of living inside your own programming.

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