Joan Frances returned to Cambridge feeling tremendous guilt and wanting to die. She unpacked from her trip, fingering the bottles of pills her mother had provided to help with her nervous stomach. “If I took all hundred and fifty of these pills, I would probably die,” she thought. “I’m never going to be what my mother wants.”
Then she found the slip of paper given to her before the trip by the internist. She had the name and phone number of Dr. Barry Tate. Joan Frances thought it might be futile to talk to a psychiatrist, but then considered the finality of death. “Maybe I’ll give it one more try,” she thought. “I’ll call this psychiatrist, and I won’t lie to him. I won’t pretend. I won’t let him think I’m a multiple personality. I’ll just be honest and tell him that I want to die because I can’t please my mother. Maybe this doctor can help me become the daughter my mother wants.”
Joan Frances called Dr. Tate and set up an appointment.
I called Lynn. “I’m not sure how I feel about Joan Frances seeing this psychiatrist, but it’s better than an overdose,” I said. “I’m really worried about her depression.”
“Why don’t you take the Flock to see Dr. Matthews?” Lynn asked. “He said he’d be available to you in emergencies.”
“I don’t think that would work,” I said. “Joan Frances doesn’t trust him, because he knows we’re multiple. She still thinks that if she denies the rest of us her mother might love her. I think that if I take her to Dr. Matthews she will just feel more trapped and confused by her lack of control.”
I pointed out that, despite Joan Frances’s depression, she was moving forward. “This may actually be a breakthrough for Joan Frances. It’s the first time that she, as a separate personality, has ever decided to seek anyone’s help. I think she feels more desperate than ever about not being able to please Nancy. Maybe she’s really ready to hear that her survival doesn’t depend on Mother. The fact that she decided to see this doctor may make her more willing to listen.”
“So are the rest of you going to stay in the background while Joan Frances sees the doctor?” Lynn asked. “Are you all going to try to hide your being multiple from Dr. Tate?”
“No,” I said, after a pause, “I don’t think that will work. Joan Frances has never had enough strength to stay out on her own for very long unless her mother is around. My guess is that the doctor’s questions will make her feel so uncomfortable that she’ll lose time to another personality.”
Then I had an idea. “Lynn, would you call Dr. Tate before we go in to see him and explain the situation? That way you can check him out. If you think Dr. Tate won’t be able to help Joan Frances with her mother obsession knowing that we’re multiple, I’ll just cancel the appointment.”
Lynn wasn’t sure. “You know, Renee, Dr. Tate may see my call as interference.”
“Well, if he does, then we’ll know that he’s not the kind of doctor Joan Frances should see,” I said.
I had to be careful in approaching Dr. Tate. I knew nothing about him, but knew that he might well resent the implication that I was telling him what to do, particularly since I was not an M.D. Therefore, I began by telling him that I was approaching him only because Multiple Personality Disorder was relatively rare and I didn’t know if he had had experience with it. Knowing the Flock as well as I did, I might be able to help.
Dr. Tate seemed warm and accepting. I was encouraged and described Joan Frances’s most recent trauma with her mother. I told him that, although the Flock as a whole was not suicidal, Joan Frances was feeling very depressed. The rest of the Flock would work against any of Joan Frances’s suicidal impulses, but that personality’s depression needed to be addressed.
I thought that he might be able to get through to Joan Frances in a way that I could not. Dr. Tate was a new person, whom Joan Frances had chosen to see; she interpreted any help taken from me as disloyalty to her mother.
I suggested that Renee and Jo might be very helpful—Renee because of her broad understanding of the group, and Jo because she had by now read everything published on the disorder. I stressed that the group wanted to help Joan Frances through this crisis and that they would all provide what help they could.
DR. TATE WAS NOT available for another five days, and I worked to keep Joan Frances as comfortable as possible, but a crisis was brewing.
Bethany sat me down one evening. “Renee,” she said, “I have to tell you that Joan Frances is driving me crazy. She won’t leave me alone.”
“Sorry about that,” I said to Bethany. “Joan Frances isn’t much fun for anyone right now. I’ll try to keep her out of your way.” I didn’t need to alienate my roommate on top of everything else.
Jo learned about Joan Frances’s upcoming appointment with a psychiatrist from my notes on the group calendar. At first Jo objected: a strange psychiatrist’s office was the last place she wanted to find herself. But she talked to Lynn and wrote in her journal about the differences between her own new feelings of self-worth and Joan Frances’s perceived worthlessness. Jo wrote:
I’ve started thinking about how close I’ve come to committing suicide. The first time I can remember feeling suicidal, I was ten years old. I sat on my bedroom window ledge, wondering if it would hurt very much if I jumped. With my new sense of well-being, I know that I’ll never feel suicidal again. But I think that now I understand how suicides happen.
The possibility of death came closer each time I felt suicidal. The most difficult part of any suicide is the actual decision to die. Once that struggle is completed, once that decision is made, the act that brings about death is anticlimactic.
A lot of people probably misunderstand what it’s like to feel suicidal. They think that repeated threats mean that the suicide is less likely to happen. I think that the reverse is true.
If making the decision to die is the most difficult part of suicide, then that decision-making becomes easier with practice. The decision is tremendously hard the first time, a struggle the second and third. But then there comes a time when the thought that death would be better is almost simultaneous with the fixing on a method. Reaching for pills, a razor blade, the window becomes reflexive.
Most suicides are probably the result of years of practice, so that the thought and action become blended into one. I suspect that the final act happens quickly, with little fear.
Now I’m grateful that Lynn always took my suicidal feelings seriously. I wonder how many suicides are successful because the potential helper thinks that the suicidal person is calling “wolf,” when in fact every threat pulls the victim closer to the actual event.
I was uneasy about letting a doctor so near to the Harvard community know that I was multiple, but I felt bolstered by the talk Lynn had had with Dr. Tate.
The personalities agreed that this was to be, as much as possible, Joan Frances’s appointment. She was the one in crisis.
Joan Frances spent forty-five minutes telling Dr. Tate about her wonderful mother and how much she wanted to please Nancy. She explained that she had come to the doctor because she felt terribly depressed and despaired of ever being what her mother wanted.
When Dr. Tate said that he had had a call from Lynn Wilson, Joan Frances cringed. “Lynn is all wrong,” she said. “I’m not a multiple. My mother says so. She should know.” Joan Frances told the doctor that, if she couldn’t figure out how to be the daughter her mother wanted, she might as well die.
I pushed Joan Frances aside a few minutes before the end of the session. I introduced myself to Dr. Tate and told him that I was available and willing to do what I could to help.
“Joan Frances really needs someone to talk to right now,” I said. “She doesn’t think life is worth living if she can’t please her mother. Everyone inside, Joan Frances included, hopes that talking with you will make her feel less dependent on her mother’s approval.” Dr. Tate didn’t comment on my analysis, but said that he wanted to see me again in two weeks.
THE WEEKS BETWEEN THE appointments were hard on the Flock. Joan Frances’s depression was dragging everyone down. I felt continually on guard, watching so that Joan Frances did nothing physically harmful.
I took the time at the beginning of the next appointment with Dr. Tate, hoping that I could give the doctor enough information so that he could really start helping Joan Frances.
“Joan Frances has got to talk this through,” I said to Dr. Tate, and then set out to answer his many questions about the Flock’s past. When, after an abbreviated history and explanation of the etiology of the disorder, Dr. Tate focused on how poorly I had handled my relationships with Keith and Steve, I sensed I was wasting precious time. The problem right now was Joan Frances’s depression, not how I handled relationships with men. I slipped inside and pushed Joan Frances out.
“What can I do to help you?” Dr. Tate was asking as Joan Frances became aware of her surroundings. She brushed aside the confusion of how she had gotten to Dr. Tate’s office and answered, “I want to become a better person; I want to stop feeling that death is the only answer.”
Dr. Tate cut her off. “Can you put me in touch with Renee?” he asked. Joan Frances looked at the doctor helplessly, but answered firmly, “I am not a multiple.”
“Nevertheless,” the psychiatrist persisted, “can you put me in touch with Renee?”
Tears ran down Joan Frances’s face. “Please, can’t you help me?” she asked, and then felt overwhelmed. How did she make people think she was multiple when she wasn’t? Why wouldn’t this doctor help her? Why didn’t the doctor care how bad she was feeling?
Then Dr. Tate found himself with a personality he hadn’t met.
Jo looked around, taking in the doctor’s office. She quickly figured out where she must be and smiled hesitantly at the psychiatrist. “Lynn said that I don’t have to cover things up for you,” Jo said. “You are Dr. Tate, aren’t you?”
“Yes,” he said, “and who are you?”
Jo identified herself.
“Can you put me in touch with Renee?” the doctor asked.
“No, I can’t,” Jo explained slowly, ready to help the doctor understand. “I’m largely amnestic and I seem not to have the ability to control which personality is out, but I do have a lot of theoretical knowledge about MPD.” Jo told Dr. Tate how grateful she was that Joan Frances finally had someone to talk to.
“Your time is up,” Dr. Tate said.
“Am I to see you again?” Jo asked. “Definitely,” responded the doctor. “How about March 1?” Jo shifted uneasily; she never knew her schedule without looking to see what the other personalities had penciled in. I took over and agreed on the date and time for our next appointment.
“You know, Renee, talking about your relationships with men made you uncomfortable,” Dr. Tate observed.
“Well, yes, I suppose that’s true,” I replied politely.
“And that’s why you lost time!” he ended triumphantly.
“What should I do about Joan Frances’s depression?” I asked.
“We’ll talk about that next time,” the doctor promised.
I left Dr. Tate’s office very worried. The doctor didn’t seem to understand that Joan Frances was in crisis and getting worse. March 1 was yet another two weeks away, and I was struggling day by day to keep Joan Frances from acting on her self-destructive impulse.
TWO DAYS LATER, I called Dr. Tate. “I’m really worried about Joan Frances,” I said. “I don’t think she can wait another couple of weeks.”
“What do you want me to do?” Dr. Tate asked. I thought that was obvious. “I would like you to see Joan Frances before March 1,” I said.
The doctor said that wasn’t possible; he was all booked up. “I understand that you’re busy,” I said, “and I’m open to other suggestions. I’ve got to find a way to help Joan Frances feel better about herself. I just don’t think I can get through two more weeks of monitoring her actions and keeping the rest of us going. When I tell you how serious Joan Frances’s need is, I don’t feel you are hearing me.”
Dr. Tate replied that it was difficult to do an evaluation-intake on a multiple.
Yes, I could appreciate that, but…Suddenly I knew there was nothing left to say. I’d have to find a way to struggle through on my own.
That night, I removed a razor blade from Joan Frances’s hand and tried to keep busy enough to remain the personality in control. The next day, Saturday, I worked in the library from opening to closing—anything to avoid the dorm room, where Joan Frances might surface. By Sunday night, I was exhausted and Joan Frances had found another razor blade.
She scratched her wrist and watched drops of blood form on the cut and run down her arm. “I’m worthless, an utter waste,” she said. “My mother can’t stand me no matter what I do.” She ran the blade across her skin again. “Even that Dr. Tate didn’t care how bad I felt. All he wanted to do was tell me that I had multiple personalities.” This time, she stabbed at her wrist with the blade’s sharp point. “Why doesn’t anyone care how I feel?” The blood and tears welled up simultaneously. “I’m not worth it, that’s why.”
I pushed Joan Frances aside, wiped the blood from my wrist, and tried to control my trembling hands. I felt so alone. There was no sense in calling Lynn. She couldn’t do anything from such a distance, and Joan Frances wouldn’t talk to Lynn anyway. But I knew she needed to talk with someone.
I called Harvard Health Service and told the nurse on call that I had a friend who was feeling suicidal. I hoped they would have a hotline number my friend could call. “Tell your friend to come into the emergency room,” the nurse said. “She can talk to a nurse, the internist, or we even have a psychiatrist on call. There are professionals here who can help.”
I thanked the nurse and tried to maintain control by doing some reading for a course. At 11:00 p.m., I found Joan Frances again scratching her wrist. I had to get out of the dorm room.
I walked through the night, fighting to stay in control and trying to decide how best to handle the situation. I didn’t want to die; Jo didn’t want to die; not even Joan Frances really wanted to die. But her depression and need were overwhelming the system.
No other personality could reach Joan Frances to let her know that we were there and caring for her. We could only try to control her actions.
“This is really absurd,” I thought. The situation seemed incredibly simple to me—Joan Frances felt bad because she couldn’t please her mother and she wanted to talk to somebody about that. Being a multiple had little to do with her immediate crisis.
Even now Joan Frances was reaching out. The scratches on my wrist were far from life-threatening. She was punishing herself, not trying to die. She was asking, as loudly as she could, if there weren’t someone willing to pay attention to her and her pain. “I’m trying, sweetie,” I murmured.
After I noticed the avidity with which Joan Frances was watching the cars speeding by her, I steered her toward the emergency-room entrance at the health service. Rather than have to explain we were multiple—Joan Frances was the problem, not multiple selves—I allowed Joan Frances fully into consciousness as I pushed the body through the emergency-room door.
Joan Frances blinked uncertainly in the bright lights and at her own disorientation. She hadn’t made the decision to come here. Or had she? A nurse looked at her and led her quickly into a back room. “What’s wrong with you?” the nurse asked. “Have you been drinking? What drugs have you taken?”
Joan Frances bridled at the questions. She didn’t drink except for an occasional glass of wine with her mother, and she would never use illegal drugs. But that all seemed like too much effort to say. The nurse wouldn’t understand any more than anyone else had. Finally, Joan Frances told the nurse that she had cut herself and pushed up her sleeve to expose her bleeding wrist.
“I don’t really want to die,” Joan Frances began. “I just feel so bad and nobody will listen….”
The nurse cut her off. “Do you know Dr. Tate?” she asked.
“Yes,” Joan Frances said, startled to hear the doctor’s name.
“Dr. Tate is the psychiatrist on call tonight,” the nurse said, and left the room.
I was as startled as Joan Frances by this new bit of information, and inwardly mused that coming in may not have been such a great idea. I had no idea that he moonlighted with the service. If Dr. Tate had not heard Joan Frances’s need during our office visits, I didn’t hold out much hope that he’d understand now. But I reminded myself that Dr. Tate didn’t have to get involved in this. The emergency room was filled with nurses. There was an internist on duty. Any of them could spend a little time talking with Joan Frances and helping her feel less depressed.
The internist came into the examining room and handed the phone to Joan Frances. Dr. Tate was on the other end.
Dr. Tate angrily demanded to know why Joan Frances had cut her wrist. “What happened tonight to make you do this? Did you know I was the psychiatrist on call tonight?”
“No,” Joan Frances replied. There was no special reason she had acted this way tonight. The depression was just getting worse, and no one was listening.
“I can’t decide if you belong upstairs in the infirmary or if I should put you on a psychiatric ward,” Dr. Tate said.
Joan Frances hung up the phone, shrugged into her jacket, and walked out of the examining room toward the entrance hall. The doctor and nurse stood in front of her, blocking her way to the exit.
Trapped. The scene bent, twisted. The image of walls, walls everywhere, trapping and releasing, shook me from my own shock. Josie, I realized, was very close to surfacing. “No, Josie, not now,” I pleaded silently. “Let us handle it. Stay inside.”
Joan Frances calmly told the doctor and nurse that she was fine now and just wanted to go back to the dorm.
I was furious. I knew Lynn had told Dr. Tate how terrified we all were of commitment. All we wanted now, as we had wanted for the past month, was for someone to talk with Joan Frances and help her through her depression. Despite Joan Frances’s panic at Dr. Tate’s threat, she was acting far less hysterical than many of us were feeling. For now, we let Joan Frances stay in control.
The internist led her back to the examining room and sat down near her. “I’ve called Dr. Tate,” he said, “and he’s coming in to talk with you.”
“I don’t want to talk with anyone,” Joan Frances responded shakily. “I want to go back to my dorm.”
The internist soothed her: “There’s nothing for you to fear. No one can make you remain here against your will,” he said. “I wish you would stay, because I know that you’ll feel better after you’ve had a chance to talk with Dr. Tate about what’s troubling you. Give him a chance. Why don’t you wait here for him to come in?”
The desire to run vibrated throughout the Flock, but I stifled the urge. “Look, gang,” I said internally, “what if we tried to leave and someone physically prevented us? You know that would bring Josie, and we’d be sure to get locked up.”
And I had a ray of hope that the internist meant what he said. Maybe Dr. Tate finally did understand that Joan Frances needed to talk. I calmed the personalities poised for flight and held back the others so as not to interfere with Joan Frances. I wanted her ready and willing to interact with the psychiatrist.
Dr. Tate arrived, demanding to know specifically what had happened tonight to make Joan Frances feel so bad. Joan Frances had no new answers; she had felt like this since her return from Virginia.
“What do you want me to do?” the doctor asked.
Joan Frances shook her head in bewilderment. She had told this doctor what she wanted so often that it seemed silly to repeat the litany. “I don’t want you to do anything,” Joan Frances finally said. “I just want to go back to the dorm.”
“No,” Dr. Tate said firmly, “I’m having you admitted to a locked ward.” Joan Frances lost awareness in a rush.
Jo found herself in the small examining room. No windows. No clue as to whether it was day or night. “There’s a sliding wall instead of a door in front of me,” Jo observed silently, “and Dr. Tate is sitting in front of that exit.” Jo looked at her watch, checking for the time, knowing that her gesture was clumsy, obvious, but she didn’t care. Her hands were clammy. She felt very frightened, but didn’t know why. Maybe if she could figure out where she was and what was going on…
“Well, ask,” Dr. Tate said.
Jo relaxed instantly. Dr. Tate’s reaction was so much like the way Lynn responded when Jo appeared suddenly, feeling anxious and confused.
“Where am I?” Jo asked.
“The emergency room at Harvard Health Service,” Dr. Tate said.
“Why?”
“Look at your wrist,” the psychiatrist said.
Jo again looked at her watch, confused by the doctor’s direction.
“No,” Dr. Tate said with a trace of irritation, “look at your other wrist.”
Jo looked, inspected the cuts long enough to realize that they were not dangerous, and said, “Oh, this has happened before. Joan Frances’s work, I’d guess.”
Dr. Tate looked a little startled by Jo’s blasé attitude.
“Oh, I know this is a problem,” Jo said. “It’s something to be taken seriously. But Lynn calls this a gesture, not a suicidal act. She says that these scratches are the way that a really troubled personality broadcasts her need. If Joan Frances had been serious about killing herself, she would have taken an overdose.”
“Who are you?” Dr. Tate asked.
Now it was Jo’s turn to look startled. She knew she had talked to the psychiatrist during one of the Flock’s two visits to his office. Didn’t Dr. Tate remember?
“I’m Jo,” she finally said, slowly and carefully. “Don’t you remember talking to me?” Dr. Tate said nothing, but watched Jo for a time silently. Jo began to shift uneasily in her chair, feeling like a bug pinned to a board. “I want to go back to my dorm room now,” she said.
“No,” Dr. Tate said matter-of-factly. “As soon as I can find you a bed, you’re going into a psychiatric ward.”
Jo didn’t panic. Lynn had told her that there was no reason for the Flock to be locked up. “Lynn told me that I’m supposed to call a Boston psychiatrist by the name of Timothy Matthews if someone tries to lock me up,” she said. She remained calm. All she had to do was to follow the emergency procedures Lynn and I had worked through.
“Have you ever seen this Dr. Matthews,” Dr. Tate asked, “or is he only a name to you?”
Honest to the last, Jo sighed. “That’s a really ambiguous question.”
“At least you haven’t lost your sense of humor,” Dr. Tate responded dryly.
“I’m not trying to be funny,” Jo said. “I know that some of the other personalities have met with Dr. Matthews, but I’ve never talked with him personally.”
“Well, it’s one a.m.,” Dr. Tate said, “far too late to call another doctor.”
Jo wondered why he wasn’t being more helpful, but didn’t panic. All of the contingencies had been worked through. For once, she knew the plan.
“Dr. Matthews gave me his home phone number so that I could reach him whenever I needed,” she explained.
“Well, where’s the number?” Dr. Tate asked, sounding annoyed.
Suddenly Jo realized that this doctor didn’t want anyone to rescue her. She began to feel trapped and frightened. She frantically patted her coat pockets and found no number, nothing in her jeans pockets either. The phone numbers, Jo suspected, were back at the dormitory.
“You don’t have the number here, and you’re not in good enough shape to be out on the streets. I’m having you pink-slipped!” said Dr. Tate.
Jo took a deep breath. That was impossible. “I want to call Lynn,” she said.
“Your therapist in Denver can’t help you,” the psychiatrist said firmly.
“Lynn is in Chicago, not Denver,” Jo responded with equal control. “I’m very frightened by what you are suggesting and I want to call Lynn.”
Finally, Dr. Tate led Jo to a phone. “Don’t stay on the phone all night,” he warned. “I’m tired and I want to get home to bed.”
Jo glanced curiously at the doctor, not wanting to believe that the psychiatrist was really so unconcerned about the crisis that he was now escalating. Though she felt surges of panic, she had to appear calm and in control.
When Lynn’s answering machine picked up at the first ring, Jo quickly hung up and dialed again, knowing that the phone had to ring at least a couple of times before it would wake Lynn or Gordon. “Unless Lynn can help,” Jo realized with certainty, “this doctor is going to have me committed.”
Lynn answered sleepily, but quickly became more alert as Jo filled her in on the situation and handed the phone to Dr. Tate. “This woman has no impulse control,” Dr. Tate shouted long-distance, and Jo gratefully gave up the consciousness.
I took over. I stood quietly, listening to Dr. Tate’s side of the conversation, imagining how helpless and concerned Lynn must be feeling. I seethed with anger. I concentrated on that anger, letting it grow to replace some of the terror that triggered the Flock’s need for flight.
I was frightened, more frightened than I could ever remember being. Psychiatric hospitalization. There was no way I could convince myself that it might not be so bad. We’d be restrained, drugged. I pushed the fear aside and concentrated on my anger.
“Stupid, stupid, stupid!” I muttered. I was angry at myself for not realizing how this situation might be perceived. Joan Frances’s depression was not nearly as life-threatening as commitment.
I was angry at the internist who had lied to Joan Frances. The doctor had said that no one could lock her up against her will, and Dr. Tate was preparing to do just that.
Dr. Tate hung up the phone and turned to me. I smiled broadly and said, “Tell you what. How about if I make an appointment with Dr. Matthews and you let me out of here so that we can both go home and get some sleep?”
“Renee?” Dr. Tate asked. He seemed weary and agreed to let me go, but only on the condition that I reach Dr. Matthews before I leave.
“His phone numbers are back at the dorm,” I said, “but I’ll call my roommate and have her find them for me.”
“No,” Dr. Tate said, “I don’t want any more people involved in this. I’ll reach him through his answering service at the hospital.”
While Dr. Tate called the hospital, demanding to be put in touch with Dr. Matthews now, I docilely followed the nurse into another room to have my wrist cleaned and bandaged. “Don’t worry about hurting me,” I said to the nurse cheerfully. “I know the cuts aren’t that bad.” The nurse said nothing. Her hands shook as she washed the cuts. The nurse finished bandaging my wrist, and Dr. Tate came in with the internist.
“You’ve got to see this,” Dr. Tate said to the other doctor. “This is Renee, the in-charge personality.”
I smiled brightly at the internist and thanked him for being so helpful with Joan Frances. “If they think I’m serious, then I’m a better actress than anyone has ever given me credit for being,” I mused silently.
Dr. Matthews didn’t return Dr. Tate’s call, despite his demands, and the psychiatrist was tired. He offered a compromise. If I stayed overnight in the school’s infirmary, he wouldn’t have me committed.
I knew that wasn’t good enough. The threat of hospitalization had shaken us all. I had to get someplace where everyone felt safe, and I needed to get there fast. “No,” I replied breezily, “I’m going home to the dorm.”
“But, Renee, I want you to be comfortable with the infirmary so that you’ll feel you can use it in a crisis.”
I bit my tongue to keep from asking why he hadn’t recommended the infirmary days ago, when I had called about Joan Frances’s crisis. This was no time for a debate.
“I can have you committed, you know,” the doctor said.
I decided that if that were so he would have done it by now. I looked at the doctor calmly, steadily, and told him that I was in full control.
“How do you know that you’ll remain in control?” Dr. Tate asked.
“Fear,” I lied. “The rest of the Flock is so scared they’re not going to surface for a very long time.”
“I don’t like fear being your method of control,” Dr. Tate said.
Silently I countered that that was obviously the method he preferred, but I grinned conspiratorially at him. “At this point, I’ll take what I can get.”
Dr. Tate gave in. I walked out into the night, feeling more protected than frightened by the now empty streets. I got to the dorm and called Lynn. In the hour between phone conversations, she had been figuring out the quickest way to get to Boston.
I was exhausted, unnerved by the experience, but pleased that the Flock had worked together. Lynn and I were both giddy with relief.
“I’d like to strangle him,” Lynn said.
“Yet more evidence of your extreme countertransference,” I countered.
Just before we hung up, Lynn chuckled. “We’ll both probably sleep better than Dr. Tate tonight,” she said.
“I hope so,” I agreed. “The bastard deserves to worry.”
The next evening, Bethany came into my bedroom and sat down. “I saw the cuts on your arm and I called Lynn,” she said. “Lynn said that everything is under control, but that I should talk with you about it.” I told Bethany the story, just as I had told Lillian earlier in the day. Lillian had known something was wrong when I missed class. Bethany said, as Lillian had, that I should tell her when someone in the Flock was in trouble. Then she paused.
“Could I talk with Joan Frances?” she asked.
“I’m not sure,” I said. “Things are a little chaotic, but let me try.”
“Hi, Bethany,” Joan Frances said. “Did you have a good time at the movies last night?”
“Cut the crap, Joan Frances,” Bethany said. “I know you are having a rough time.”
“Oh, I’m OK, there’s nothing wrong. I just need to try harder.”
“Joan Frances, you may not understand this, but I want you to listen,” Bethany said. “You are a really neat person. You are smarter than anyone I know. You’re cute, you care about other people, and when you are not worried about whether or not I hate you, you are a nice person to have around. Basically, what I’m telling you, kiddo, is that, if your mother can’t see that, she’s crazy.”
Bethany got up and walked out of the room before Joan Frances had a chance to protest.
I kept my March 1 appointment with Dr. Tate. This was my chance, I decided, to make him understand how damaging this experience had been for the Flock.
“There’s a difference between a suicidal personality and a suicidal entity,” I told Dr. Tate. “Yes, Joan Frances was depressed, but her suicidal gesture was after two weeks in which Joan Frances, Jo, and I all tried to tell you that she was in crisis. She needed a professional ear far more than she needed an ‘intake-evaluation,’ but you never seemed to hear that.”
Dr. Tate shot back that I was manipulative. The Flock had been called that so often by people who didn’t understand that the label had no sting. “I can have you withdrawn from school if I decide you can’t manage in the Harvard community,” he warned. I nodded and left his office. His threat was clear, and I’d keep my distance.
The Flock’s experience has made me think long and hard about what is needed to treat a multiple and how to convey this to others. In spite of all of my best efforts to smooth the way for the Flock with Dr. Tate, they landed in greater jeopardy than at any time since I began working with them. Ironically, they’ve never been healthier or better able to articulate their needs.
I attempted to be clear and straightforward in my approach to Dr. Tate, deferring to his medical expertise and stating my desire merely to be helpful. Renee and Joan Frances, in turn, were clear and straightforward about their needs in a way that was new for them. Yet we were seen as manipulative multiple and puppet therapist. Renee had probably never been less manipulative in her life than when she was trying to reason with Dr. Tate.
I can’t help speculating on what happened between this psychiatrist and the Flock. Renee secured and sent me Tate’s clinical reports, but they only add to my confusion.
The psychiatrist wrote that he found the dramatic changes hard to believe. He described Renee as attractive, confident, intelligent, dynamic, and reasonable. He described Joan Frances as depressed, schizoid, and childlike.
My guess is that Dr. Tate just couldn’t accept Renee’s explanation of what was wrong and what needed to be done with Joan Frances. He interpreted Renee’s willingness to help and Jo’s willingness to teach as no less indicative of pathology than Joan Frances’s cries for help.
Perhaps he even saw my warning that the suicidal personality needed urgently to be addressed as some sort of warning that the Flock would attempt to manipulate him. I’ll probably never know. I don’t think that either the Flock or I could have handled the situation much differently, but it’s clear that the doctor felt very threatened.
Somehow this disorder hooks into all kinds of fears and insecurities in many clinicians. The flamboyance of the multiple, her intelligence and ability to conceptualize the disorder, coupled with suicidal impulses of various orders of seriousness, all seem to mask for many therapists the underlying pain, dependency, and need that are very much part of the process. In many ways, a professional dealing with a multiple in crisis is in the same position as a parent dealing with a two-year-old or with an adolescent’s acting-out behavior. It is essential for the parent or the therapist to accept and not be threatened by any manipulation that does occur and to help the child, teenager, or patient understand that there are better ways of communicating and meeting needs.
The Flock have come a long way in their acceptance of this, and when a professional refused to deal with them in a straightforward manner—and, in fact, manipulated and deceived them in return—they rebelled fiercely but self-protectively.
I made the clear and, I hope, threatening statement that night, all deference put aside, that I knew this patient better than he did and unqualifiedly recommended against hospitalization. I said firmly that I was certain that hospitalization would do them more harm than turning them free. My implied threat, combined with Renee’s obvious presentation of competence, secured the Flock’s release.
There are some “silver linings” even in this horrible experience. Renee felt and expressed justified anger. She was able to share her experience with Bethany and Lillian and receive support from them in turn. I gather that even Joan Frances listened to what Bethany had to say.
It is clear that the Flock is continually becoming stronger and less dependent on our therapeutic relationship. I suspect that Renee will turn some of her energies toward her relationship with Steve and others she cares for.