Speak Out For Mental Health Care Access
After attempting suicide and being labeled "difficult," Linda had a hard time finding a therapist who would accept her as a patient (California).
Though intended to help, the agreement alienated Linda from her doctor. Just as her cutting and attempts to take her life had blocked open communication with family and friends who couldn't understand her behavior, now she could no longer confide in her psychiatrist. Linda didn't want to harm herself but, at times, she felt compelled. So she covered up the slivers of evidence she carved into her ankles, kept her therapy appointments, and pretended those self-inflicted injuries didn't exist.
"The contract put me in a horrible bind," says Linda. She depended on her psychiatrist to help her gain control over her self-injury, which had become "a sort of obsession." Yet the contract implied she already had control. "The person you're supposed to be most honest and open with, you're lying to. So, it was very damaging and not a good thing at all," Linda says. Yet, desperate for security, she never considered looking for a new doctor to replace the one on which she had come to heavily rely.
Linda carried the contract around in her purse, intending to keep her promise yet doubting she really could. Each hidden self-inflicted injury tugged her farther away from her psychiatrist's help. Finally, when she again attempted to take her life, and was hospitalized, her secret was out.
In her book, Half in Love: Surviving the Legacy of Suicide (Counterpoint – Berkeley, 2011), Linda describes the aftermath of her first failed attempt to take her life: "I had crossed an invisible line—one that, conceivably, I might never step back over again." This time, however, she had crossed a very visible line, marked in dark ink by her signature on a page. She'd breached her psychiatrist's boundary, and he followed through with the consequences. He ended their relationship.
"I was sad and overwhelmed," says Linda. "Disappointed in him as a doctor and also terrified, because it meant I had to find someone new at a time when I was totally vulnerable."
Linda's psychiatrist unfairly stereotyped her as a "difficult patient," one that would be equally "difficult" to place. Over the telephone, he gave her two names, saying these were the only two he could find who might take her on. The situation brought up abandonment issues. Her mother, poetess Anne Sexton, had been in and out of psychiatric hospitals, and eventually took her life when Linda was 21.
"Here is the clinician you've trusted and counted on," says Linda, "and he disappeared. Being told up front you'll be difficult to place offers little hope."
Thankfully, Linda found an ideal fit from the short list of two names her psychiatrist provided her. She had an advantage many people do not—she had the financial means to pay out of pocket for services. The relationship has continued for more than a decade. Exploring her earlier classification as "difficult" was part of Linda's healing. From the start, Linda's new doctor was open and willing to discuss Linda's cutting. If Linda slipped back, and gave in to the compulsion, she could bring that to the therapy then work through the accompanying emotions.
Looking back, Linda understands that her former psychiatrist's use of the contract may have related to the clinician's own issues and concerns. "Suicide is the ultimate in your face experience with death," says Linda, who believes the societal taboo may impact some therapists' willingness to confront it.
For anyone who has had trouble finding a therapist, Linda suggests meeting with those who have indicated that they work with all kinds of patients. "You have to get started right away." Linda says. "Take a leap of faith. Meet with the person, and if it doesn't work, move on to the next."
Linda is grateful to have found a doctor willing to jointly examine her darkest depths, while offering the promise of future good. She calls the final chapter of her book, "Hope," which is what she now possesses for herself, and holds out for others.