Chapter Six
Day Treatment and Night Rescue1
ecky's charge, Marie, had spent the last never been away from Indonesia, and she was
B month in Stepping Stones, the Day Treat- ment Center, on my referral. Becky did not approve of what she saw happening. Not only blissful to be invited to visit our country. She did turn out to be useful, I believe." Becky: "Thank you for that, Michael. I was it doing Marie no good, it was causing her appreciated Mona's help. Therapy has been going harm. Her charge was then going through inten- very vigorously, and that is why the alter- sive psychotherapy and the day treatment pro- -personalities have been acting out so much. I gram took up time she needed to absorb the les- expected that. But now we have the added prob- sons she was learning in therapy. lem of having to deal with other patients who At night, after Marie had gone to sleep, have no desire to get well. I have tried to talk to Becky made psychic contact with Michael, my their Essences, but they are on their first assign- Essence, and told him that they needed to meet to ments, so they are not much better than their determine where they were going with this Step- charges." ping Stones matter. Being fast asleep at home, I Michael: "Becky, you have been used to had no idea that my Michael and Marie's Becky working with Ralph and have expected him to do were conferring. miracles. He keeps trying to please you by doing Becky: "Marie has been in Stepping so. He thinks some of what happens are miracles, Stones for four weeks now, and today she had to such as the rituals I do when you give him a meet with the Psychiatric Nurse, Debra Down, tough assignment in therapy. You really keep him and the Mental Health Worker, Fred Martinez, to busy." set out her treatment plan. They don't seem to Becky: "OK, Michael, so I push a little, know anymore now what to do than they did but I have a job to do, to get my charge well. when she started there. Why did Ralph want her Now you and Ralph are planning to move in a to go to this useless program?" few months. What kind of cooperation do you Michael: "Becky, I explained it to you, call that?" and you agreed we could go ahead and try. I Michael: "Becky, remember how Ralph know you had little enthusiasm for Stepping is working at his maximum, even with my help, Stones. You know that, after Ralph and his fam- when he has to cover all the work in Broderick, ily came back from that trip to the Far East, he one day in Woodland, and one afternoon in the found you exhausted because you and the CIE county jail. Then Dennis and the Woodland clinic had been having so much trouble keeping peace psychiatrists couldn't work out a renewal of their in Marie's mind. We brought Mona back from contract. That was when Dennis told Ralph he Bali to relieve you and the CIE so you could get would have to share the night and weekend call your psychic energy recharged. I invited Mona to schedule with the other salaried doctors. You and come visit the United States for a while. She had I both know how responsible Ralph takes his job, The first section of this story is told through the "eyes" of the Essences of the two individuals involved in Marie's therapy plan, Becky, Marie's Essence, and Michael, Dr. Allison's Essence. These are the actual conversations that took place, as dictated to their charges. The setting is the night of July 2, 1980.
but the pressures got to him again, and he has least he thought all those reasons were enough to another ulcer. I told him to calm down, but he refer her to Stepping Stones." wouldn't listen to me. He wrote that letter to Den- Becky: "Well, they may have sounded nis' boss, and all that did was get Dennis embar- like excellent reasons to him, but for myself and rassed and irritated with Ralph. my charge, Marie, it was not an excellent idea. Becky: "Michael, you know that the let- As far as I can tell, the referral was more to treat ter got Dennis back to negotiating with Doctors him and his anxieties rather than to treat Marie's Lucien and Romero. Then we contacted the mental problems." Woodland Clinic administrator's Essence. When Michael: "I agree with you, but that is he told the doctors to make up with Dennis, they the way he has been trained. In medical school, suddenly found ways to compromise on the con- he accepted lots of principles that sometimes get tract." in the way. I have a hard time getting him to ig- Michael: "Yes, sometimes Ralph's impul- nore some of those old ways of doing things and sive moves do have a positive outcome, even listen to my advice instead. I'm gaining every though he doesn't expect them to. That is when I day. But give me time." take advantage of a situation he has created and Becky: "Michael, maybe you can explain think of ways to turn a potential catastrophe into why the Stepping Stones' staff insisted on my a triumph. This was one of them. But the die was charge agreeing to that absurd treatment contract cast; his mind was made up, and nothing I could they asked her to develop and agree to at today's say was going to change his mind about leaving meeting? Can you explain to me why they made this job. Now it's just a matter of finding a better her list her problem areas? Why didn't they just place to move to where he can find a decent job." call on me? I could have listed Marie's problem Becky: "So we have only ten months in areas, just like I do with Ralph anytime he asks which our charges will be working together. Con- me to." sidering the job we have to do, that's not much Michael: "I know that. First, you are time. I cannot afford to waste any of it with Step- aware by now that the staff members are acting ping Stones. I don't see what good it will do for as if they agree with Ralph that Marie has MPD. Marie. Why did he send her there, anyway?" But they don't believe it, so they don't act appro- Michael: "He was upset at finding you priately. If they don't believe she has MPD, how and the others so tired when he came home. Your can they believe she has an ISH named Becky, charge was living at Sihaya House where they who knows all about her? So they ask Marie; insisted she have structured activities each day who else can they ask?" outside the house. He knew he could not always Becky: "Of course you are correct. We be available, and he needed a competent mental both know she can't change her character. So health person who would be on hand for Marie to when they listed the problems she has, how do go to. He hoped a Psychiatric Nurse would have they expect her to change them, and by a certain enough experience to deal properly with Marie date? and her other personalities. He needed to have "Here are the problems Sad Marie listed: backup outside the hospital, so he could keep her "1. Difficulty starting conversation with out of the clutches of Dr. Lucien. He needed to others. do something that would show the other Mental "2. Difficulty with anger and personality Health staff he was doing all he could to avoid change. burdening them with one crisis after another. At "3. Depression.
"4. Acting out behavior by Marcia, Joy- leen, and Mary. "The first three are inherent in Sad Ma- rie's nature. I should know; I put them there to keep her alive in that marriage. If she didn't have difficulty starting conversations with others, George would have been sure she was stepping out on him. If she didn't control all her anger and move it onto Marcia, Joyleen or Mary, she would have been beaten even more than she already was. If she wasn't depressed, do you think any of the psychiatrists she had seen would have had her come back for more therapy? Finally, it got her into the clinic just before Ralph showed up. By the way, you surely took your time getting him to move out of Santa Cruz to Davis. What took you so long?" Michael: "First, it took me a while be- cause he had invested a great deal of himself into the Santa Cruz scene, with running the Mental Health Service, then setting up the Suicide Pre- vention Service, and then opening the psychiatric ward. I had to get the new hospital administrator to turn the ward over to the neurosurgeons to make him lose enough money to get him to listen to me. When he has enough money coming in, he doesn't want to change. What human does? I had to make him lose enough so he would be willing to move to Yolo County so he could meet Marie. "Secondly, I know those items on that list are impossible to change in Sad Marie. That fourth item, about the acting out of the al ter-personalities, shows how little in touch they were about the dynamics of her condition. Since she has no control over what they do, so how can that be HER problem?" Becky: "Then just look at the list of 'Short-Term Goals' they noted for her: "1. Decrease depression. "2. Increase assertiveness skills. "3. Increase socialization skills. "4. Deal with anger without perso
intend to follow through, what good is a promise mitment to do something other than overdose was on a piece of paper?" a major accomplishment. Michael: "Remember, one of Ralph's "In this case, the staff member in the past lives as a barrister comes in handy to ex- Day Treatment Center feels a lot better when he plain that. You know that lawyers have had more or she has in hand a written agreement from of an influence on American culture than their somebody in Sad Marie's body that she will not value warrants. They have persuaded everyone -- kill herself or anyone else. That allows the staff doctors and nurses included -- that written con- member to relax and get on with today's business. tracts are more binding and impressive than oral That is very important to therapists, I assure you. contracts. If that is so, how did we get by with Who can do therapy when their adrenaline is oral contracts for so many centuries before flowing because he or she is wondering what agreed upon written languages were invented? damage the patient is going to do next? I know Humans now have the illusion that, when some- Ralph can't, so he has to do something to calm one signs a contract, that guarantees that the himself down. Getting the patient to sign a no-vi promise will be acted on. But they fail to note the olence contract is one thing that can calm a thera- tremendous increase in fraud and false advertis- pist down quickly, I assure you." ing suits in courts these days." Becky: "Michael, we have had plenty of Becky: "That brings up another thing experience in stopping these suicide attempts of that gets me about the Stepping Stone staff -- the hers. We are doing so well in therapy with you contracts they expect Marcia, Mary, and Joyleen and Ralph that I know that she is not going to kill to sign, promising that they will not come out and herself, no matter how many contracts she signs. harm Sad Marie while she is in the Day Treat- So why should they bother? Hasn't Ralph told ment Center or on field trips with the staff. What them what he is doing in therapy, so they will makes them think any one of them will follow know how far she has come since they started through on any agreement they make? They were working together?" created to hold Sad Marie's anger against various Michael: " I know you would feel more people, and that is what they will do. As long as blissful if the Day Treatment staff knew how to she has a glimmer of hope, they will do their best treat someone with MPD properly. I know you to dash that hope. That is what they are there for. think Ralph should have set up training sessions Signing a contract isn't going to change their na- with the staff and educated them in what he has tures." learned over the past decade. But when I brought Michael: "But you are not looking at it that up with him last, he balked at my suggestion through the eyes of the staff. Ralph and I have that he tell them they needed training sessions spent years looking at problems through the eyes with him on MPD. He thought that, if he did that, of patients. When Ralph set up and ran the Sui- they would think he considered them stupid and cide Prevention Service of Santa Cruz County, he would feel insulted. They might even take it out trained the phone volunteers to ask suicidal call- on Marie, since they wouldn't dare take it out on ers to commit themselves to a plan of action for him. You know how one doctor in Santa Cruz the immediate future. That may only be to flush took out on Ralph's patients in the hospital the the pills down the toilet, go to bed, and show up anger he had toward Ralph. He didn't want that at their psychiatrist's office the next morning for to happen here, too. I tried to tell him that these their scheduled appointment. But the fact that the were two different situations, with different peo- person on the other end of the line made a com- ple, and that I could persuade the staff members' Essences to be open to his concepts. But you
know how he is -- once burned, no way will he ideas all the time. Why doesn't he teach the Es- take the risk again. He decided that only if the sences and bypass the human minds?" staff ask him for a training session will he give Michael: "I thought of that, but so far he one. And so far they haven't asked, have they?" really isn't as well attuned to me as he could be, Becky: "This is what you call Ralph's so he still has limited faith that I can help him out political thinking, right? He is more concerned in that way. All he will believe is from his own with his relationships with the other staff than he experience. When the hard-nosed critics didn't is the benefit of my charge, and I think he is in- believe what he had to say, he decided to just correct to think that way." stick to treating people until others were ready to Michael: "I agree with you, Becky, but hear what he had to say. He didn't get the feeling you know how we both have to work. We can that the staff was open to what he had to say. I only tell our charges what we think they ought to tried to persuade him that even if one of them do. Barring a life and death risk, we cannot over- understood 10 percent of what he was saying, it rule their decision to act in a certain way. All we would be worth the risk. But he wasn't willing to can to is educate and persuade. But force them take the chance on insulting the intelligence of the we cannot. We both are bound by that principle, others. You have to remember that the two senior and sometimes it makes our job just that much staff members are female, the nurse and OT harder. worker. With the troubles he had in his childhood "He also had hoped the training the staff with his own sister, he has never been comfort- had in school would help them figure out for able approaching females and telling them they themselves what was going on with Sad Marie, needed to listen to what he had to say. He would but he was incorrect in that assumption. He didn't be much more comfortable if they were men, but listen to me when I warned him he was assuming they aren't. too much. I wish he was not so quick about as- "The only man on the team is Fred Mar- suming anything. In this case, it was more of his tinez, the Mental Health Worker, and you know wishes needing fulfillment than of his calculating he only has a high school education. He may be a the odds that this would be true. He should have nice human, with a level head and all, but he known that no nursing schools are teaching any- doesn't yet have the basic education in psycholog- thing about MPD. That is why he had to start the ical principles to understand much of what Ralph training program for the American Psychiatric needs to explain. It would have gone completely Association. Once the psychiatrists know some- over Fred's head and would have done him no thing about it, then they will expect the nurses to good at all. In fact, it might just confuse him in- know the same material. But there hasn't been stead. So we thought we should just let Fred time for his lessons to have spread that far yet. 'wing it,' and hope his good intentions would out- We need more time and helpers for that to hap- weigh his lack of knowledge and experience. pen." Maybe in a few years, he will be able to learn Becky: "So you tried to get him to set up enough to be a good therapist, but now is not the a training program for the Stepping Stones staff, time to expect that." and he would not unless they asked him first. Becky: "But Fred was assigned as Sad These humans sometimes have the feeling that Marie's primary therapist! We had expected that others will not listen to new ideas or advice un- such a complicated patient as Marie would be less they ask for it. Maybe that is true of the hu- assigned to the nurse, Debra Down. Now she is man part of them, but you and I, and other Es- only the director, not the therapist. If things went sences like us, are open to new information and wrong, she could blame Fred, who would plead
ignorance, and be correct. She would be expected only had leftovers to work with to make Sad Ma- to know more than he did. What a mess!" rie. It was enough to get the body around, and I'm Michael: "She is responsible for half of not apologizing to anyone. I had nothing on hand the ideas on that first treatment plan you don't strong enough to contain anger, as that takes a like, and I don't like it either. Let's look at those container of major strength, and there was none 'Short-Term Goals' and see if any of them make of that material left. I had to design her so she any sense." would pass all her anger onto one of the angry Becky: "OK, Michael. I've stated my alter-personalities, and you know how that position for now. Let's see if we can salvage any- works. thing from this situation. Here's what I think of "Now that doesn't mean she can't meet each of those goals Sad Marie is expected to that goal, in the sense of not splitting anymore reach. because of anger. But I don't think they under- "1. Decrease depression. She has al- stand it that way. I think they want her to never ways been depressed, as that is in her nature. shift into an angry alter-personality when she, What can they expect to do about that? Ralph Sad Marie, gets angry at someone who insults has prescribed antidepressant medicine, and it her. But that is the way I had to design her, so I hasn't done all that much good, but, without it, think they are going to have to take her as she is. she would probably be in bed all day long instead "5. Increase self esteem. That is a nice of at the Day Treatment Center. I'm not sure idea, but how can they do that? She is what she which is worse! is, and she knows she is temporary and will cease "2. Increase assertiveness skills. How to exist as a separate being when integration time can you become more assertive when you are comes next year. How can anyone increase the designed to be passive and inadequate in contrast self esteem of someone who knows they are to your husband? Maybe they can teach her a doomed to cease existing in such a short time? I few ways to not get pushed around so much. will wait to see what they mean by that one. Anything would be better than her doormat ap- "6. Decrease acting out behavior. That proach to life. So let's give them credit for a is the most irrational of all. Sad Marie never acts good idea here. We'll see how it goes. out, so she is perfect on that point. You and I "3. Increase socialization skills. All her know that they mean that the 'angry psychic sis- socialization skills were placed into other al ters' will not come out to do their things, and that ter-personalities, such as Lisa Kay. When she is impossible to prevent. We can minimize the integrates all of them into her, then she will be damage they do to people and things, but we can- quite the socializer. So I don't see what the staff not stop them from acting out in the first place. have to work within that area. You know I am always cleaning up the messes of "4. Deal with anger without personal- those angry ones, with the aid of the helpers. ity split. Now that is impossible to expect from That is the way the system works. Until you and her, the Sad Marie. She is made up of the flimsi- Ralph are finished with the therapy, that is what est of personality parts, as I didn't have much they will have to expect. So I don't think they are raw material to work with that day. I had to grab going to be able to do much with that goal. what was left on the shelves in the 'personality "Now let's look at the 'Long-Term traits warehouse,' and that wasn't much. I had Goals,' shall we, Michael? Why don't you tell me already used all the strongest parts for the helper what you think of those?" alter-personalities, since she kept making the an- Michael: "OK, Becky, here is what I gry and suicidal ones too fast for my comfort. I think of these two items.
"1. Increase work skills. She has fin- tiveness training, stress management and re- ished high school and received a certificate from laxation techniques. that Dental Assistant school. When she was "This is their standard program. They working as a dental assistant to an orthodontist, intend to immerse Sad Marie in their entire pro- she became upset at the lack of clear and concise gram, and therefore it is the staff's intention that instructions. Then the angry alter-personality, something will work. Lisa Kay, came out and threw metal trays at the "2. Meet with Debra Down and Fred doctor, and he fired her on the spot. Her anger Martinez weekly. Now what is that all about? was expressed, shall we say, excessively and in- Does that mean she is to have individual psycho- appropriately. It isn't that she can't learn a job; therapy with two other therapists besides Ralph? her trouble is keeping her emotions under control All the other clients in this center are chronically on the job. So it really doesn't matter what job mentally ill or brain damaged patients who only skills she has. They cannot compensate for her see their therapist once a month, at best, for sup- lack of anger control when she is the slightest bit portive interviews, as they call it. But with Sad irritated. So I think that goal, while noble, needs Marie in twice a week intensive hypnotherapy to wait until integration is accomplished. She is a with you and Ralph, what are these other ses- client of the Department of Rehabilitation, but I sions supposed to do? I wish they had made some hear from my Essence sources that her counselor, clarification of that item before she was expected Haley Richmond, is looking toward a promotion, to sign it. which will require she move out of the area. You "It sounds here that they want Sad Marie and I both know that Haley is the best there is in to have more therapists, and that is going to get this business, so we need her in a position where her even more confused. After all, your charge is her ideas can become reality. In the meantime, we our pick for Sad Marie's therapist -- not anybody are going to have to work with her replacement, else. Doesn't your charge know what is happen- and I think you will have your hands full with ing? that lady. I don't envy you having the problems I "3. Participate in all phases of Day see coming from that quarter. Treatment program to increase her socializa- "2. Go through Voc. Rehab. for a job. tion skills. Michael, refer to my comments on She has been a client of Haley and the Voc. Re- item number one. hab. agency for two years now. So that is just a "4. Be more assertive in her day to day rehash of number one, and that is all there is. experiences. That is fine to say, but she has to be "Now, let's look at what they propose as able to do it, and we know she isn't. methods to accomplish these noble goals. That is "5. Initiate written and verbal con- what the inspectors look at very closely -- how tracts with the other personalities to deal with the planned actions agree with the problems, not acting out behavior and set limits. What is the whether or not they will work. To me and thee point of written contracts when the al that seems more important. Don't you agree, ter-personality has been programmed to behave Becky?" the way they behave? They will just violate the Becky: "I agree, Michael. Now here are contract. Oh, I know the argument that you and the actions they have listed that should be done. Ralph use, that it can work when you are precise "1. Attend the Stepping Stones Pro- in the terms of the contract. I know how literal all gram on Mondays, Wednesdays, and Fridays. alter-personalities are in interpreting any terms of Actively involve self in self-awareness group a contract. But, if the alter-personality wants to therapy, independent living skills, and asser- do something, he or she will do it, regardless of
what piece of paper they signed. To them, it is mind without getting our ideas on it. I hope you just that, a piece of paper. Only Sad Marie her- two have learned a lesson from this." self is designed to take such contracts seriously, Michael: "I already have learned it, but so you could say that no-suicide contracts with Ralph's attitudes are another thing entirely. If he her might be useful in stalling her until she gets had brought the idea to you for discussion early out of there, and there is no contract covering her enough, what would you have advised him?" behavior out of doors. Becky: "I would have told him that, with "Marcia just had to come out and object the intensive therapy he was doing with our to the whole affair. She was bound and deter- charge twice a week, what she needed was rest mined to block everything and wasn't about to let afterwards, not more stimulation. Is spite of his Sad Marie come to the center. But I knew she experience, he doesn't seem to realize what an was just jealous of Sad Marie getting all the at- energy toll his type of therapy takes on a patient." tention. She wanted her share, and that is why Michael: "Actually, he does, but he didn't she came out. But she couldn't say that to the want to remember. I tried to remind him. In Santa staff. That would have been too polite for her Cruz, several of his regular MPD patients ar- style. ranged for therapy in the afternoon before a day "Then Faith told me to come out and ex- off. They were so worn out with his therapy they plain what was going on with Marcia to Debra were no good at the office or store, where they and Fred. That way I could gauge their reaction needed to be alert. There was no way they could to me, the ISH, and see if they were open to in- work after he put them through his mill. You structions from me. I pulled Marcia back inside know how persistent he is when he knows he is and came out myself. I explained how Marcia going in the right direction in therapy." was, and how she would interfere if she wasn't Becky: "Yes, Michel, we know. Remem- given private time with Fred equal to what he ber we, you and I, were already destined to work gave Marie. Debra and Fred seemed to under- together. That is why I would have advised him stand me; at least they didn't object to anything I that he should have insisted Sad Marie have a said. They agreed to allot Marcia equal time, and day off from all required activities on the two that made her happy. She had been accepted as days after her therapy hours. He should have told her own person, and that is all she wanted from that to the staff at Sihaya House, since they insist them. all clients be out of the house during the day at "With that stumbling block passed, Sad some activity." Marie was accepted as a regular client in Step- Michael: "He was worried, that, if Sad ping Stones, and now we are stuck with the situa- Marie had nowhere to go and nothing to do, one tion, it seems. of the angry alter-personalities would have gotten "I do wish I had been able to talk to her into more trouble. He just didn't feel he could Ralph about this referral before he made it. But risk that, with the limited time he has left here." he had his mind made up, and he didn't want to Becky: "There he goes again, worrying hear anything I might say about it. If he had been that we can't keep her out of trouble. We know willing to listen, he would have heard both Faith what is best for her at this time, and we would and myself tell him Sad Marie would be causing not let anyone inside do anything to block his a lot more problems than before with her con- therapy. I could have assured him of that, if he stant calls for help. You know that Faith and I had asked. But he didn't ask us, and that is why were most attentive when Ralph had made up his we are in this awkward situation today. Now, we need to help Sad Marie survive the Stepping
Stones experience. Please get Ralph over there to pared a no-violence contract that we would like give them some instructions on how to deal with you to sign for us. Would you be willing to sign someone with MPD before too long." that you will not harm Marie, or anyone else, Michael: "Becky, Ralph is holding back here at the center or while on trips with staff and until someone asks him to come talk with them. clients? How about it, Mary?" He is afraid of implying that they don't know Mary looked at me as if I had rocks in what they are doing, when both of us know that my head. How could I be so foolish as to think is exactly the problem. I will take it up with him that she would do something like that -- promise again, just before he wakes up this morning, and not to kick ass! But then she looked at Martinez, see if I can get past his self-protective political and saw the flashes of fear in his aura, and she thinking. But I'm not going to promise you any- realized that he was in a state of perpetual panic thing." over what Sad Marie might do on his shift. She Becky: "Well, at least I have stated my realized that he was not her enemy, and if he case, and I will leave that job up to you. Thanks freaked out, Sad Marie would be in serious trou- for joining me tonight for this discussion. I know ble with someone she didn't want to deal with. that our charges are stirring, so it's time we got She knew that Becky and Faith could give her a back to them so we can steer them on this new hard time if she didn't try to cooperate. She didn't day ahead." even want to think of what Hope and Charity With that farewell, Becky and Michael would be able to do to her. separated life forces, and returned to their respec- She took the pen and glared at me. With tive charges, Becky to Sad Marie and Michael to a laugh, she said, "I'll sign the contact, but I will Dr. Allison. They had their work of the day to still do what I want to do. This is just a piece of do, some with other Essences, and some with paper." She signed and retreated inside, to be re- each other. At least they had cleared the air and placed by Joyleen. both were better prepared than before to do their "Go to hell, you two jerks!" barked Joy- jobs in helping their human charges with living leen. She glared at me, and I stared right back at their lives. her, holding my own. I was not angry, like she **** was, just firm and determined to get my way that The next day, Fred Martinez, Marie's day. assigned "staff person" in Stepping Stones, called "Joyleen, I presume," I said. "Just calm me to come help him deal with Marie's "angry down and read this agreement we want you to psychic sisters." With the exception of Marcia, sign. We want you to agree not to harm anyone they felt ignored by all that had been going on. here or on field trips. Otherwise, Fred and Debra They had told Martinez, in no uncertain terms, can't allow Marie to attend. I think that would be that they had thoughts and feelings, too, and he a pity." had better get Dr. Allison over there to listen to "I don't give a shit what Marie does or them. Martinez complied, since he had no idea wants to do," Joyleen retorted. "What's in it for what to do next. me?" Martinez and I called in Sad Marie and "If you keep your eyes and ears open, told her we needed to talk to some of those inside you might learn a new thing or two here, your- her. In her usual compliant response to her doc- self," I suggested. "Maybe you could learn to tor, she closed her eyes, and I called for Mary to make things yourself, and even have some fun." I come out. When she did, I said, "Hello, Mary. I was appealing to the good side I hoped against think you know Fred Martinez here. He has pre- hope was there. I was right.
"Now that might make it worth staying "Twice a week, she will be in the Inde- around this junky place, Doc. I'll take you up on pendent Living Skill class, where she can learn to that. Give me the pen." With that, she signed the make a budget, handle money, reconcile a check- no-violence agreement, too. book, clean, cook, and other housekeeping When she retreated inside, Marcia came skills," Martinez replied. out for her turn. In spite of the fact she had al- "That sounds good," I said. My patient ready been a party to Sad Marie's agreement, I had graduated from high school and Dental As- never was sure how she was going to behave sistant school, had attended Junior College last when she saw me. Usually, she took a swing at year, and had been married for several years, all me. the while keeping a household operating while This time, I was relieved to see she was raising a child. I wondered if she should be taking in a noncombative posture. When I put the paper this class or teaching it. Again, I kept my with the proposed nonviolence agreement in front thoughts to myself. of her, she laughed. "Why should I care about Becky communed to Michael, "Let's that BITCH, Marie, coming here? I'll sign your have my charge run this class. She has more ex- fucking contract, but I will kill her where and perience than anyone in this place, and it would whenever I want to, and no damn piece of paper make everyone take notice." is going to stop me." With that pronouncement, Martinez continued, "It seems that the she took the pen and signed her name as well. best group for her will be the Assertiveness With those three "committed to a life of Training group each Friday from 2:00 to 3:00 peaceful coexistence," Martinez visibly relaxed, p.m. There she will learn the difference between and leaned back in his chair. I excused Sad Marie assertiveness and aggressiveness. That seems to and turned to him. "Fred, would you now explain be an important problem for her, so she should to me just what you and Debra are going to have get a lot out of that one. There she will have a my patient doing over here in this trailer? What chance to role play handling social conflict differ- have I gotten her in for, now that we have gone ently than she usually does." though these hoops?" "Fine, I hope so," I said. I had seen the "Dr. Allison," Martinez responded, "here difference between those two approaches demon- is what the schedule is. Three mornings a week, strated many times. Becky was assertive, and she will attend the Self Awareness group at 10:00 Lisa Kay, Lynn, and the other nasty ones were a.m. for an hour. That is where we try to help the aggressive. But Sad Marie was passive, as was clients discover what is inside themselves." required to keep her alive at the time of her cre- "That should be interesting for Marie," I ation. Even if she intellectually learned the differ- said, keeping my other thoughts to myself. I won- ence, what could she do with that knowledge? dered what the staff would do when they found Becky knew Sad Marie was not assertive inside Sad Marie what I kept finding there. But I because Becky had not made her that way. Becky didn't want to upset an already anxious Martinez had made her passive, and she would not even be with that question. around much longer. It was getting time for Dr. When Becky heard this, she knew I could Allison to meet the Original Personality. Every- see that this was the wrong place for her charge. one should give Sad Marie time and stop trying He is going to pull Sad Marie out. Or at least ask to force her to change, because she couldn't. me what I think about it. "Then, we have Stress Management and "What else do you have planned?" I Relaxation class every day after lunch. That is asked. when all the clients lie on the floor while we play
soft music and Debra has them take trips in their seemed. But when I watched my multiples in imagination." group, I found they were indeed special. They That idea scared me, but I kept my lips switched personalities in group, and all the other shut. I knew what a caldron of imagery there was patients kept dealing with them as the center of inside Sad Marie's mind, as that is where we attention. As a result, they destroyed the useful- spent our therapy time together. To just ask her ness of the group for those other patients who to wander off into that no-man's land of visual- could have gained from a more normal group ization could be downright risky for her. Who experience. I thought it better for the other pa- knew what she might come up with? She was a tients to keep my multiples out of her therapy virtuoso at hypnotic procedures, as were all mul- group. tiples, so Down had better be good at what she At this time, Sad Marie saw Stepping was doing. I hoped that no alter-personalities Stones as a place where she might be able to would pick that time to come out, since Sad Ma- make new friends, but inside, she knew she was rie would be passively following instructions to dying. Therapy with me was intense and difficult, give up control of the body, and that would leave but she was doing her best to bring the others to the door wide open for anyone to come out. But I me for treatment. I still didn't talk to her much, had made this referral for my own reasons, and I but then, nobody had ever wanted to talk with didn't wish to look foolish by pulling my patient her. Nobody wanted to have anything to do with out now, when everyone had cooperated with me her, so she was always suicidal. She did what so well. everyone wanted her to do as if she had no mind Becky was distressed with that an- of her own. All she wanted to do was die, but nouncement. She was almost yelling at Michael, nobody would let her. "Take her out of this place! It will be a total di- During the next week, Sad Marie was saster for her and for Dr. Allison. Michael, get dropped from a two day a week volunteer job her out, NOW!" because Marcia kept coming out to argue with Martinez continued. "Of course there is everyone and mess up the paperwork Marie had the Occupational Therapy time first thing every started. Down then extended her Day Treatment morning from 9:00 to 10:00. In the afternoons, contract to five days a week. This would give her we may have an outing scheduled. That is when the same time structure each day. Since Marcia we all go in the van for a field trip. I hope Marie had not agreed to attend those extra two days, will enjoy those." Martinez and Down called her out to sign a new So did I. I had sent her here, and now I contract for a five-day program. She reluctantly was having second thoughts. But I wasn't going cooperated, as long as they stuck to her original to back down. I had no experience with how pa- terms. Marcia could see that Sad Marie was mis- tients behaved in such a setting. In Santa Cruz, erable being there, which suited her fine. every inpatient had been expected to go to the Sad Marie had had a problem with one group therapy run by the Psychiatric Social of the men who also attended. He called her Worker. I had refused to allow my multiples to names, then acted overly friendly and started attend her groups, and she became upset with me. touching her in a seductive way. She didn't like She believed my multiples should be required to him or his behavior, and, with the encouragement meet all the requirements that were laid out for of the Assertiveness Training lessons, she asked the other patients, or they would consider them- him to stop his annoying behavior in what, for selves "special," a dirty word to the Social Work- her, was an assertive fashion. He got her message er. No one should be considered special, it
and stopped touching her. She did not like being would think something strange and forbidden had touched. been going on. Becky was very proud of Sad Marie. She Sad Marie continued to describe how Dr. had learned something new, but it was too little Allison had let Marcia shove out of herself all too late. She was dying as the time for integration that anger until she was just a shell. Then she was getting closer. told how he put his hand on her head and told her Sad Marie came back to Stepping Stones to let in all the healing energy of the universe, to after the court appearance by Marcia, Megan, replace the anger. Becky, and herself. After I next converted Marcia At this point, Down just about lost her into a helper, she wanted to tell Down how it cool. Now we have a religious nut on our hands, happened. Sad Marie asked to see her alone so invoking heavenly forces when he was hired to she could explain how Marcia had changed. do psychotherapy, she thought. What did he She told her how Dr. Allison had discov- think he was, a preacher? And in a tax sup- ered Marcia had a need to go to probate court ported clinic, at that! She wondered if she should because she had never had a chance to challenge report him to Dr. McIver. But in front of her was her father's will, in which he had disinherited all a previously very disturbed lady who was telling his children. Dr. Allison had asked her if she her that this strange psychiatrist had actually would give up all the anger she had stored converted an angry alter-personality into a help- against her father and other men who rejected er. Not only was that impossible, but he had her. She described how he had put a can of mod- dared to do it with religious concepts and eling clay in Marcia's hands and told her to shove phrases. In addition, he had put his hand on a all her anger into the can. patient's head. No psychiatrist these days was While Sad Marie described what she supposed to touch a patient, or he ran the risk of thought was a wonderfully useful procedure, the being sued for sexual battery. What kind of Psychiatric Nurse was sitting there, wondering chances was this guy running, doing these weird where Dr. McIver had gotten this screwball of a rituals with clinic patients? psychiatrist. She had watched him during the Down was afraid of what she was hear- time he was here, and he had acted okay when ing -- that Dr. Allison was preaching religion and she had called on him. What was this stuff about not doing psychotherapy. But this was one asking patients to shove "anger energy" into cans messed up patient, and nobody could believe a of anything? She had never heard of that any- crazy lady like her! where in her professional training, so he had to Marie told her that, after Marcia had be somewhere far out in left field. And this gull- taken in the healing, loving energy from above ible patient actually believed it had done her her head, she had told the doctor he was the fa- some good. Gawd, some people will believe any- ther she had always longed for, and that she thing! loved him. Becky listened to Sad Marie and tried to At that point, the nurse was about ready tell her to keep quiet. Down was not going to be- to bring a halt to the whole story, and call Dr. lieve what her charge was saying, as she didn't McIver for a confrontation. Not only did we have understand. But Sad Marie would not listen to a doctor practicing religion right here in their her ISH and Essence, and Becky was not about public clinic, he was encouraging a vulnerable to come out and tell her that they couldn't talk female patient to fall in love with him! This was about it with anyone. Then, for sure, Down too much! What was he going to do next, divorce his wife and marry her?
Down knew this patient had to be lying "I will listen to whatever Marie wants to about what Dr. Allison was doing in therapy, talk to me about. But I will not press her to dis- because he was a happily married man. She knew cuss anything she doesn't want to talk about. I he loved his wife and children and would never certainly will not press the issue of her father's want a divorce. So everything Sad Marie was death. But I will listen to her if she wants to tell saying must be a lie. me about it." But Sad Marie didn't pick up on her feel- "Listen, you knucklehead," Joyleen an- ings and kept talking about what had happened to swered. "I hate her father, and I don't want to her. She told Down that reviewing the feelings hear you or Marie talking about him. Do I make about the loss of her father had been one of the myself clear?" subjects keeping her depressed recently. Down "Perfectly clear," replied Down. "Now, asked her to tell her more about what it had why don't you go back inside and let me talk to meant to her when she learned her father had Marie again." died. That is what a good Psychiatric Nurse Joyleen felt she had gotten her message should ask about, when the patient brings up a across and left, being replaced by Sad Marie. sensitive subject. Down told her what had happened with Joyleen's Inside Sad Marie, Joyleen had been lis- interruption, and Sad Marie sighed with embar- tening and watching Down, and she didn't like the rassment. way this conversation was going. Whereas Sad Then she was surprised to see Down pull Marie had asked for the time to share her joy at out a piece of paper and pencil, as she knew that having made a breakthrough in therapy, the nurse meant she was expected to sign another no-sui- was seeing bad things that weren't there, and that cide agreement. She had signed so many of them would not be good for any of them. Joyleen was here, but she was still sure she was going to die, alert enough to know that this was neither the so why not do it now? time nor place for Sad Marie to talk about her Passive as always, when Down asked her father. That subject belonged in Dr. Allison's of- to sign that she would not kill herself for a week, fice and no place else. She wanted this conversa- she was ready to sign as requested. But she was tion to stop. She was getting angry with the way too honest to do so. She told Down that she could Down was responding. only make that promise for the next 24 hours. Joyleen popped out and told the nurse so. Down nodded and said, "Well, sign that you will "Just a minute, Debra. You just hold on there. not commit suicide in the next 24 hours, and I You had better leave Marie alone, and don't you will accept that. When you come back tomorrow, dare talk to her about her father!" Her glare said we will have to deal with that then." more than her words. Becky thought, "Oh, no, not another Down decided that she was not about to suicide contract. I am so tired of these pieces of let a patient tell her what she could or could not paper. Michael, talk to your charge. Have Ralph talk about to "someone else." She decided to take Marie out, or at least talk to Faith or my- stand her ground and refuse to be told what to do self." by this one, whoever she might be. After all, she Sad Marie signed the paper, got up and was the trained Psychiatric Nurse, and she was left the room. She knew she was going to die the one who should know what to talk about to a within the next two days, so what did one day client of hers. So she decided to pull a "strategic matter to her? She didn't want to upset Down any withdrawal" and compromise. more than she had already. She had tried to tell her about the most wonderful thing that had hap-
pened to her in therapy in a long while, but she I replied, "Last week, when she was at didn't get the impression that the nurse was as age 25, I met two new characters, Robert and happy about it as she was. For her to be happy Grace. I didn't get any information about what about anything was a major accomplishment. they were up to. I wonder if they have anything The next day, Down called me. "Doctor, to do with this problem?" I've got troubles with Marie, and you had better "It might be wise to look into that, Doc- see her with me. She was really upset yesterday. tor," answered Becky, in her usual inscrutable Joyleen came out and blasted me for talking fashion. about her father. We had thought she was doing I decided to do an age-regression right so well, going through that wild court action last then and there and asked Sad Marie to go back to week, but now she is suicidal again, and I can't when she was 25-years-old. In a few moments, I get an agreement beyond today. I don't know was talking to a 25-year-old woman in a 30-year- what to do next." old body. I asked her what was then going on in I could feel the panic in Down's usually her life. calm and professional demeanor. After all, she When Down saw me age regress Sad was a well trained Psychiatric Nurse, but dealing Marie, she was intrigued with what she saw. with someone like Sad Marie took a toll on any Maybe he wasn't crazy after all. She watched and therapist, no matter how well versed in matters of learned. mental illness. I decided to take my lunch break "I've been having lots of trouble keeping at Stepping Stones, and see what I could do with jobs," the age regressed Marie said. "I was work- my most complicated multiple. ing at the church I go to, helping out in the office. When I met with Sad Marie and Down at But the minister kept giving me too many instruc- lunch, I called Becky out to explain what was tions too fast, and I couldn't keep them all going on. "Dr. Allison, Marie is planning to over- straight. Then when I forgot to do just one little dose tonight when she gets home from here. She thing, he yelled at me! When I yelled back, he also plans to cut herself up with some razor fired me! It isn't fair, when I worked so hard to blades. I think the best thing to do is for us to go please him!" She was near sobbing as she told into the hospital from here and get things calmed about losing that job. down inside. I don't see any way to avoid her "Then," she continued, "I got a job as hurting herself if she goes back to Sihaya House receptionist at an insurance office. Some of the this afternoon." people came in to complain that they hadn't got- Down watched this therapy process, but ten the checks they had been promised, and they she could not understand why a psychiatrist expected me to fix it all up for them. Finally, I would call out another personality to find out couldn't take the pressure anymore and snapped what was happening. Is this what happened in back at one of the clients. He didn't like that and therapy, that Dr. Allison didn't know what to do told my boss. He let me go that afternoon. What with this patient? Down noticed this time that, did he expect me to do with all those angry peo- when Becky spoke, she knew what was happen- ple, just sit there and take it all day?" ing. Down noticed something quite different At this point, her expression flickered about her, something that she hadn't noticed be- and the familiar face of Megan, the helper, ap- fore. Becky had a special look, a smile that peared. "Hi, Dr. A. We really did a thing on seemed heavenly, a special look in her eye that Marcia in court the other day, didn't we? I'm sure totally caught her off guard. Maybe Sad Marie glad you got her straightened around. Now we had MPD! have these other two to deal with."
"Just how do Robert and Grace fit into Megan continued, "Since they both came the picture, Megan?" I asked. from similar situations, they teamed up together "Grace was created when she was having to give her hell. For a while they would tell her troubles with the church job. She acted up so that how bad she was, no wonder no one wanted her Marie could get fired and get out from under- to work for them, what a failure she was, and neath that pressure. Marie would never admit how she deserved to die. Then they would tell her that she didn't like a job or wanted to leave. She not to be so hard on herself, that she had a right would rather stay there and suffer. Well, Grace to blow up at those folks who had fired her, and made sure she got fired instead. she should get angry when she was not treated "Then, when she was working at the in- right at work. They tried to put at least some of surance company, Marie had hopes that she the blame on those she blew up at, and not take it might learn to be an agent and have a chance to all on herself. So they kept her on a roller coast- sell policies. She knew that was where the real er, up and down. Now it is mostly down, because money was. She wasn't going to get anyplace she couldn't even stay on that volunteer job she sitting at a desk in the office filing forms all day. had to quit. There, again, she quit because she But then she realized that all the sales people felt she was being given conflicting instructions, were men, and all the office staff were women. It and, no matter what she did, someone would get suddenly dawned on her that there was no way mad at her. She decided to quit before she got she, who had just been hired, would ever be al- fired again." lowed to learn how to become a salesman. That "Right now we have to make a decision is all there were, salesmen, no saleswomen at all. about sending her to the hospital again," I said. That was when Robert was made, a man who "Are there any helpers who are assigned to deal might be cross-trained into sales. But her super- with Robert and Grace?" visor didn't see it that way when Robert made "Maybe Monique could help out with 'his' pitch to him. Somehow he couldn't see her as them," answered Megan. "Bring Marie back to a 'him,' and told 'him' to get back to 'his' desk and age 30 and see if she is able to help." continue to do what 'he' had been hired to do. I then age progressed my patient up to That afternoon, Robert raised such a stink a- her present age and asked to talk to Monique, a round the office, Marie was given her pink slip helper alter-personality. When she appeared, she from that job, too." looked tired. "Doctor, this job is not turning out What Marie had described seemed like like I expected. I'm having a tough time just such minor upsets to her. She thought any fair keeping Marie from killing herself. She is so boss should let them pass. But I could see what down on herself all the time that I have to keep would happen if either Grace or Robert came out giving her pep talks, and the effect doesn't last to rile up the boss. These were full-blown rages long. I would like to help you out, but I don't they pulled, not little spats. Grace had exploded have any energy left over for Robert and Grace with such fury at the pastor/boss that he had no right now. Marie is so down right now, I don't choice but to fire her on the spot. Robert was so dare spend any time away from her. You had bet- incensed by not being recognized as the male he ter speak to Becky about that." thought he was he started tossing wastebaskets in With that, Monique disappeared, to be the air. This terrified the elderly couple who had replaced by the calm, serene Becky. She cleared come to patiently wait for "his" boss to explain to up the current mystery. "Last weekend, doctor, them why they hadn't gotten the insurance check Marie and her mother had an argument, and this they had been promised. is what is pushing Marie even farther down.
Mother was at the court hearing we were at, but swers. He didn't assume anything, and he never she sat out in the hall all the time, so she didn't asked any leading questions. The patient told him hear what happened. She expected Marie's attor- everything. She wondered if she could learn a few ney to come out and tell her what had happened. things from him, but she kept that idea to herself But she didn't! Mother was left out there listening and never told him. to all those jurors going home, muttering about When I had decided to hospitalize her what an amazing thing they had seen. She didn't charge, Becky gave way to Sad Marie, and I told have the slightest idea what they were talking her what I planned to do. She just sat there, look- about. She wondered if her daughter had done ing at the floor, realizing that she was being something in public that would embarrass her, blocked from doing what she wanted to do so now that so many people had seen her daughter often. Why didn't he just give up on her and let on the stand. She was most upset at being left her be free of this misery? He had no idea how out. terrible she felt, and he was going to make her "Even though that article appeared in the face even more unhappiness if he had his way newspaper the next day, she didn't read the paper next week. But, he was the doctor, and he could and didn't know what had happened. Marie was do with her what he wanted. Who was she any- so sure Shelly would read about it in the paper, way, just a no good, lousy patient no one cared she didn't think she had to tell her mom how the about? hearing went. Then her mom got mad at Marie I dialed the Yolo General Hospital ER for not telling her all about it, and that is what is number. I told the doctor on duty I was sending getting Marie so down today. Marie Francis Kelly in on a 72-hour hold, and I "Another thing she is upset about is your would appreciate him doing the admission work- plan to go out to her father's grave at the ceme- up. I read the medication orders from her chart tery next Monday. I agree with you the trip is and told the doctor she would be in by van from necessary, but she is dreading going out there. Stepping Stones at 4:00 p.m. Down was relieved She sees suicide as the only way to avoid that to have that all arranged. day. Sad Marie was driven to the ER by Mar- "She's in horrible shape right now, and tinez that afternoon. She spent the next two days she's also feeling ignored and rejected by the staff in the seclusion room. at Sihaya House. She thinks they should spend Becky and the CIE knew that, no matter more time with her. Without her counselor there what anybodye Tj 28ET1.00000 0.00000 0.00000 1.00000 0. anymore, she has no one who spends enough time with her. I know they are busy with other things, and Marie needs more attention than anyone else. I can't stop her from overdosing when she goes home today. All I can do is tell her not to, and, as you know, she's free to ignore me." "I know that," I replied. "I think the only safe thing to do is to put her in the seclusion room at Yolo General Hospital on a 72-hour hold." When Down had listened to everything the patient and the others had said, she was a- mazed at how Dr. Allison had gotten the an-
formed Robert and Grace into helpers and then Just before I quit that job to work full-ti integrated them into Sad Marie during the 72 me in my private office, Charlie Warren called hours she was in seclusion. They told Robert and me. He was a reporter for the Watsonville Grace they both were upset regarding the firings Pajaronian, the only newspaper in the south from their jobs. They told each of them to go county area. His wife had been a frequent patient back and see those pictures again, and remember on my ward because of suicidal depression. War- what happened just before they were fired. Both ren complained that, when in the hospital, she of them realized that their bosses were justified in had befriended the other depressed patients on the firing them because they called their bosses in- ward. She realized that many were lonely people sulting names, and they had failed to do impor- who wanted to talk to someone when they went tant duties for their bosses which caused major into the "blues." She, being a sympathetic wo- problems the bosses could not explain away. man, had given several of them her home phone Once Robert and Grace understood what and number. Now Warren was being awakened sev- how they had participated in their own firings, eral times each night by these phone calls from they freely gave up the fight and became helpers. his wife's lonely fellow sufferers. As soon as that happened, both were able to be- "Dr. Allison," he moaned, " most of these come one with Sad Marie. people just want someone to talk to in the middle ******* of the night, when they get so down. Isn't there Sad Marie was constantly suicidal dur- something you and the Mental Health Service can ing her therapy with me. Becky and the CIE had do to provide some kind of service so I can get to have some human contact readily available some sleep?" when danger reached a critical level. I could only I replied, "Charlie, I have on my desk cover emergency calls when I was in at the clinic, right now a plan for a service that would do just and the Woodland Clinic psychiatrists took all that. But I don't have any people interested in emergency calls at nights and on weekends. doing it. Besides, this plan is for a big county, Becky and I chose Yolo County's Suicide Pre- and we don't have the same situation they do. Let vention Service (SPS) as the best place for Sad me see if I can find out is going on in some small Marie to call when she feared losing emotional counties and get back to you." control. Becky knew if she asked me to always be "Thanks, Doc," he said, "and hurry up. I on call for her charge, I would soon burn out can't take any more sleepless nights and still from the overload, and she could not afford that write the stories during the day." to happen. I was the only one who could do the When I talked to Dr. McIver at the last therapy Marie needed, so other humans would meeting of State Mental Health Directors, he told have to be brought on board to handle off hours me he had started some type of suicide prevention crisis calls. phone service. I called Dr. McIver's office num- There had been no SPS when I was the ber in Woodland. When Dr. McIver came on the Mental Health Program Chief in Santa Cruz. All line, I asked him about it. distress calls were responded to by police, who "Ralph," replied Dr. McIver, "for about then brought the disturbed person to the county a year now, Joe Peterson, a former pastor, has psychiatric ward on a 72-hour hold. While I was been running a Suicide Prevention Service, using Program Chief, I attended a course at the Los volunteers who take phone calls at home. I'll Angeles Suicide Prevention Center on how to set have him call you. I'm sure he will be glad to help up and operate a SPS. But none of my clinic staff you get started there in Santa Cruz." wanted to help me set up such an operation.
I called Warren back and told him, "I've Those two items would be the only significant got a lead on someone who knows how to de- cost items. velop a Suicide Prevention Service in a small His plan required each volunteer take county. Now we need to find someone who can calls on the advertised line at home for a week. do the work. We need some advertising of the The exchange would first take the call in a pro- problem so we can find people out there inter- fessional manner and immediately transfer it to ested in being phone volunteers. That's your busi- the volunteer's home phone. The volunteer would ness, isn't it?" then listen and respond appropriately. Hopefully, "You bet it is, Doc," he said. "You give most volunteers should have a second line into me some background information, and I'll put their house, so, if need be, they could keep the together some articles on the problem of suicide caller on the line if they had to call for emergency for my paper and see what happens." services. If they didn't, they would need training I calculated statistics about the suicide on how to keep the caller calm while they dialed rates in Santa Cruz County for the past several for help. Most of the time, he had found that the years and found it to be almost as high as that of volunteer could calm the caller down well enough San Francisco, one of the leading spots in the to wait until the right arrangements had been nation. I sent this data, and all the literature I had made. gotten on the subject from the Los Angeles pro- There would be times when the caller gram, to Warren. Warren prepared three long need not come into a hospital emergency room articles which his editor placed on the front pages for help, but needed someone who could talk to of the paper. He ended the articles with a plea for him in person. Peterson had called on members of anyone interested in working to solve this prob- the clergy in Yolo County and found many will- lem contact him. ing to be available to the volunteers who thought One church group in Watsonville had a caller needed a home visitor. He recommended been discussing social problems, and several of that the local pastors and priests be contacted the members had bemoaned that they were dis- and, if willing, placed on a roster to be on call a cussing problems but not solving any. When they week at a time. read Warren's articles, they decided that this was This design had been working in Yolo a problem they should tackle together. One of County for a year. Everyone at the planning their members called Warren, who called me, and meeting in Santa Cruz County agreed to copy the from this group came the first volunteers for the design and put together a similar local service. Santa Cruz County Suicide Prevention Service. With the Watsonville church group as the origi- Peterson came to Santa Cruz to meet nal source of volunteers, more were recruited with me and leaders of the church group to ex- with newspaper notices, and I taught the first plain the plan he used in Yolo County. The de- training program for suicide prevention volun- sign was simple and required no new staff or teers. My wife managed the scheduling duties buildings and very little money. First, they had to and prepared volunteer and pastor monthly get a suitable phone number for the service, one schedules. By this time, I had resigned as Pro- that had simple numbers to dial, so a desperate gram Chief and had half my work time available person would dial it correctly. Then they needed for going around the county pulling the entire to contract with a local phone exchange, prefera- project together. I stayed on as training director bly one that already serviced doctors and hospi- for five years, when I turned the entire project tals, so the operator could cross-connect easily. over to the elected board of directors, who have
continued to operate the service successfully ever where she was, back inside the mind, so she since. couldn't hurt them. It seemed forever before he Now that I was in Yolo County, I was was back on the line. confident I could count on the local SPS doing Becky wondered if this use of the SPS its job in supporting me while I did therapy with was such a great idea. Then Michael communed Sad Marie. Her ISH and CIE realized I could not with her that Ralph had not yet talked to the handle all the problems that would be coming up, staff, but he was willing to. Becky tried to tell so they agreed with me to call the SPS whenever Wendy this, but Wendy was having such a diffi- Sad Marie needed help in keeping from killing cult time with Lisa Kay right then, Becky didn't herself. pas on that information right then. She would tell Wendy was the first alter-personality to her later when it was calmer inside her charge. call their hot line number. "My name is Wendy," Wendy asked, "Did you talk to Dr. Alli- she said to the volunteer on duty, "and Lisa Kay son, and did he confirm what I was saying?" is trying to kill Marie. I had come out to stop her. The man said, "Yes, and I have Dr. Alli- Dr. Ralph Allison is our doctor, and he has been son on the other line, and he is going to talk to treating us for multiple personality disorder. you." Right now I need help to calm down Lisa Kay so "Hi, Wendy," I said, "what's going on we will be able to sleep tonight. Then I can stop there?" worrying about Lisa Kay getting up in the middle "Marie had her son, Mark, over today, of the night and trying to destroy the body. Can Dr. A. Lisa Kay came out and slapped him on you please help?" the face and shoved him out of the room. I came The line was silent. Wendy asked, "Is out and apologized to him. I explained that it was anybody there?" She waited. Lisa Kay, not his mother, Marie, who slapped "Is this a joke?" came the reply from a him, and he seemed to understand. But Marie male voice at the other end of the line. "If it is, saw what was happening through Lisa Kay's eyes we have ways of tracking this phone call." and felt very guilty about it. Wendy repeated, "Dr. Ralph Allison is "Not only that, but another patient has our doctor. The patient's true name is Marie moved into the Satellite House, and she has no Francis Kelly, and he has been seeing Marie in money for food. She is taking Marie's food with- the Broderick office and in the Woodland office, out paying for it. Marie felt angry at her for tak- and this is no joke. We thought it would be wise ing her food, and now she is feeling guilty for to call this hot line to get help, to stop Lisa Kay feeling angry." from killing us. If you don't believe us, please "Oh, great," I said. call him. We, I mean me, Wendy, will stay in "Dr. A, this is Michelle," another voice charge, but please hurry. I am getting tired trying said on the phone. "I have a suggestion." to hold down the fort. Right now Lisa Kay is "I'm open to any new ideas," I replied. very strong." "Why don't you tell Marie to take Mark The man on the other end of the line was back to his father's place tomorrow morning and quiet, and again Wendy asked if anyone was pick him up again on Friday? That will be in time there. He said, "Yes, please hold. I'll call Dr. for the Christmas celebration. Right now, Lisa Allison to see if what you're saying is true, and Kay is too agitated to cope with him. You had then I'll know how to help you." better talk to her to calm her down. But first you Wendy waited on the line, trying to ap- had better talk to Marie about her son." pear calm, making sure Lisa Kay stayed right "OK, Michelle, let me talk to Marie."
Sad Marie came on the line, full of guilt. tal myself. She has no self confidence, and she's I told her what I had learned from Michelle and acting that way to hide how bad she feels having told her to take her son back to his father's place to live there. So take it easy on her until she can the next day. She could pick him up in time for get her bearings, will you?" the Christmas party she had planned. She reluc- "If you say so, Doc, I can keep from kill- tantly agreed. ing her for now. But she had better shape up, or After that, Wendy came back on the line they'll ship her out in a pine box! And you better and told me she thought she could handle the sit- do something about those guys in the other uation, now that Sad Marie had agreed to take house. They keep coming over to see this new her son home and not try to cope with everything gal, and they aren't paying attention to Marie at once. anymore. That really pisses me off!" When my patient came into the office the "What else are you mad about?" I asked next day, Wendy was still angry about the way patiently. I could tell she had more anger bub- she had been treated by the volunteer. If they bling in her than one problem could account for. weren't going to be of any help to them, why had "Her husband, that's who. He's been put- I told her she could call them? She had done what ting Marie down all the time, whenever he brings I told her to do, and the person who answered her boy over. He is such a jerk and an asshole. didn't know anything at all. What kind of help He treated her like shit when they were married, was that hot line going to be? and he's doing it now, too." I told her to calm down, since this was "And who else, Lisa Kay?" the first time any of Marie's "psychic sisters" had "Her father and mother! And her Aunt called the SPS. They didn't know what to say Patricia, for all the insults since her dad's wake! because they had never had any dealings with an And Sam, her stepfather. Do you know how MPD patient before. many passes he made at her?" "I haven't had time to meet with them, "I've heard about him, Lisa Kay," I said. yet," I said to Wendy. "Now that you have made I knew that there was no point in talking in detail the first call, they are going to be very curious about all these "enemies" of theirs that Lisa Kay about how do deal with the next call. I plan to was mad at. For some reason, she had built up make myself the program for their next monthly too large a charge of "anger energy," and it was training meeting. That will give me a chance to flowing out in all directions, onto anyone she explain to them what they can do when you call met. I could not afford to have her leave my of- them the next time." fice so overcharged with anger. I knew she was "Well, they don't know anything so far, serious when she told me she felt like killing Dr. A. I hope you can teach them something." somebody, anybody. I certainly didn't want it to "For now," I said, "you had better let be me! Lisa Kay come out and explain why she was so Pulling over the plastic tape dispenser on angry last night." the desk, I looked Lisa Kay in the eye and said, "I "You son-of-a-bitch!" growled Lisa Kay. can see that you are just filled to the brim with "That new roommate of hers is getting us all anger at lots of people, people whom you feel down. She takes Marie's stuff without paying for have done wrong to Marie. They may have, but it, and then she struts around like she's the Queen there is nothing either of us can do about what of Sheba! I can't stand her!" they have done. What you need to do is to let "Now just calm down, Lisa Kay," I inter- some of the anger out of you, so that you can jected. "I know that lady. I put her into the hospi-
calm down and feel better today. Are you with who had been through enough of their own per- me?" sonal crises successfully so they all knew useful Lisa Kay knew what I was up to. It was coping skills. They had been screened by the di- my "bottle routine" again, or should she say rectors and had been trained in the same proce- "modeling clay can" routine? She always felt bet- dures for managing calls which I had taught sev- ter when she had gone along and shoved her an- eral years before in Santa Cruz. As in Santa ger into the object I put in her hands, but why did Cruz, they were backed up by members of the I always have to come up with a good answer? local clergy, who represented most of the relig- After all, I was a man, and all men were shit. No ious groups in town. man could do anything good for her! Now I The meeting was one of the most pleas- wanted her to feel good again, this time by putt- ant I had attended regarding how to deal with a ing her anger into some dumb thing I handed her! person with MPD. There were no scoffers or What was I going to offer her this time, the tape skeptics there, only the intelligently curious. dispenser? These were people from all walks of life, and When I handed her the dispenser, she they had to be prepared for whatever they heard knew she was right about me again, and, damn over the phone late at night. With Wendy's first me, she was going to go along with me, again. call already logged, and their experience with my Why fight me, when I always seemed to know prompt response, they were ready to hear how to how to get her to cooperate in my stupid stunts? deal with Wendy, Michelle, or whoever might She closed her eyes, concentrated on following call them. my instructions, and shoved all the anger she I explained about the "family structure" could into the dispenser. When she had drained inside Marie's head, how the persecutors built up her anger reservoir, she threw the dispenser on anger and then unloaded it on anyone handy. I the floor, breaking off a piece of the cutting edge. listed the various helpers I knew, and alerted She then faded into oblivion. them to the ones they could call on for help. As I Michelle, a helper, came out to congratu- talked, they busily scribbled down the names I late me on getting Lisa Kay to shed her anger. mentioned in their personal notebooks, binders She then talked with me about dealing with the they kept by their phones when on call. They practical problems of living in a quarter-way were not going to be caught unawares the next house with two other equally disturbed room- time. They were too competent for that. mates. They had to figure out a way to make this My primary advice about talking to the arrangement work. If they didn't, Sad Marie helpers was to act the same way they would with would have to move back in with her mother, and any other caller. First identify the key present no one wanted that. conflict. List the options that seemed reasonably During the next week, I called the direc- available. Suggest an opinion as to which option tor of the SPS and volunteered to give their next might be best under the present circumstances. month's training program. After this first call Then ask the helper to agree to take a certain ac- from a multiple made the rounds of the volun- tion to resolve the present problem. teers, the director welcomed me to their next They knew better than to try to do psy- meeting at a volunteer's home so I could explain chotherapy over the phone. They needed to iden- what they needed to do when Marie called again. tify the trigger for the present emotional upset, I was surrounded by two dozen men and suggest a logical answer, and wait on the line women who had agreed to take crisis calls from until the caller either agreed to their answer or strangers. They were all level headed individuals came up with a better one. Only when a commit-
ment to action had been made could they hang up resented her and Michelle for insisting she keep the phone with reasonable reassurance she would coming there. not call again that night. Then, a preschool-aged Marie Francis Michael watched while his charge, Dr. came out and told about having fun with the Allison, explained everything to these wonderful presents she got for Christmas. She told me how people. Michael saw nothing but love energy much fun she had been having roaming around flowing from the volunteers. He made psychic cemeteries looking for tombstones of children. contact with Becky and communed with her that She wanted to find how many dead children were all was fine, the volunteers knew and understood. buried in each cemetery. When her charge, Marie, called them again, they I shuddered at this Addams Family view would be able to handle her calmly and effec- of life. I suggested that she might enjoy playing tively. He also told Becky, "You should see the in the local park even more. wonderful colors that surround these people. You When she faded away, Sad Marie took would be blissful staying here forever." over. She had not walked in this time, so she told On that New Year's Eve, Lisa Kay plan- me that she didn't want to be there. She stood up ned to kill Sad Marie by drinking herself to suddenly and walked out the door, pessimist that death. Wendy called the SPS and talked to the she was. worker without delay that time. Michelle also A month later, Sad Marie was not so came on the line to discuss the present crisis. Sad sad, because she felt good about signing up for Marie was depressed as usual and resented her the second semester of junior college after getting "psychic sisters" again interfering with her sui- A's and B's the first semester. Her good mood cide plans. All she wanted to do was to die and suppressed Lisa Kay for three days. In retalia- get it over with. She didn't like the others making tion, Lisa Kay kept her awake all night with her her show up for therapy when the doctor wouldn't jabbering. Finally, Sad Marie couldn't take it any even spend time with her to complain about any- longer and called the SPS. The worker listened thing. He apparently found the others more inter- patiently and waited until she calmed down. With esting to talk to. She knew she was boring and the influence of a helpful human being, Lisa Kay got on everyone's nerves. How could she help was again put in her place. that? No doctor had ever found a pill to cure her. When Sad Marie came into my office Why did no one want Sad Marie around, while next, she told me about the call. She knew there they worked so hard to keep her alive? They was a very young Marie Francis alter-personality should give up on her. She had. She had faced inside her. Becky had told her that I could meet her destiny. her if I counted backwards from five to one. On New Year's Day, Lisa Kay drank so I counted backwards from five to one. much she passed out, and no one could commit When I said, "One," she opened her eyes and suicide. When she woke up, it was the next day, looked around, as if she had never seen anything and she was so hung over she couldn't do much there before. I asked her what year it was, and at all. she replied, "Nineteen-fifty." She went through The following day, Lisa Kay dragged her purse and was surprised to find a driver's li- herself into my office and passed out again. This cense, since she had never driven a car, being too time, Wendy came out and read to me the reports young to get a license. She hadn't even started she and Michelle had written about the last two school yet! days' events. She told me how much Sad Marie While this interview was going on, Becky was talking to Michael. "What you see
here, Michael, is the personality I created to be Michael: "I'll try, but the problem is that out front after her father raped her on her first he's too anxious to find the Original Personality, birthday. This is the one I made when he de- so he jumps too quickly to the conclusion that stroyed the one I made at six months, when her any infant personality is the original. He sees mother assaulted her. She is known as Marie what he wants to see. He wants to see the original Francis and, along with Mary Lou, was in charge one so badly he will believe any baby is that one, of the body for the next four or five years. Then even though she doesn't act like an original one she couldn't grow any more and had to retire. I should. I will try to get him to keep down the just wanted you and Dr. Allison to see what she pressure on her to grow up. After all, she has was like. She has some interesting stories to tell already grown all she can. from those early years." "And that story about her father putting Marie Francis talked to the kind doctor her in the closet. If I were able to get angry, that she found in front of her. She didn't know where is certainly one thing that would have me hopping he came from or how she got into his office, but mad. What did that experience do to her later in he was nice, and she liked talking to nice people. life?" "Did you know that my father used to lock me in Becky: "That is why she and the others the closet when he said I was too bad?" she asked have always been afraid of the dark They always the psychiatrist. had to have a night light on, even now." "Why would he do a thing like that?" I Over the next few months, Sad Marie, or queried, wondering what kind of an excuse any someone using her body, called the SPS several father would have for such behavior. times, and all the workers got to know her and "He said I wasn't what he wanted in a how she would respond to their suggestions and daughter, that I should have been a boy, or that I ideas. One of the frequent volunteers was a Ro- was not good enough to be his daughter. I could- man Catholic sister who invited her to meet with n't figure out what I had done wrong, but it must her at the Newman Center, the UC Davis Catho- have been terrible. When he got done yelling at lic social center. When Sad Marie accepted her me, he would push me in there, lock the door and invitation, Sister Agnes Camellia was very sup- not let me out, even for dinner. I even had to go portive and kind to Sad Marie. She offered to potty in there." help Sad Marie in any way she could. Even "That's terrible," I replied. "There's no though she was a member of a religious order, excuse for that. You have the right to be what- she never made any judgments about Sad Marie ever you are, to feel whatever you feel, and no or tried to push religion on her in any way. Sad one can tell you differently. You are the one who Marie was very comfortable with Sister Agnes is in charge of all these other personalities, just and felt good being able to relax around a healthy like the general of the army is in charge of all his adult female who knew who she was and was soldiers." proud to be that way. Becky communed with Michael: "Mi- During the summer of 1979, Wendy chael, I think your charge has made a mistake called the SPS because her boyfriend, Bob Col- here. He thinks this Marie Francis is the Original lins, kept calling and harassing her. Collins lived Personality, and she isn't. She's the one from the in the Satellite House for men, and, after he se- first birthday, as I told you. Will you please duced Wendy, he had been warned by Jane Park- straighten him out about that? Otherwise, he will er, his Psychiatric Nurse therapist, to stay away be putting too much pressure on her to do things from the women in their duplex. But Collins had she can't do." never listened to anyone in authority so far, and
he was not about to begin now when he had tried to stay out. Finally, everyone went to sleep, found a good lay in Wendy. including all the helper alter-personalities. I was One weekend he had phoned for Wendy in a near panic, as no one would answer to my and had gotten Sad Marie instead. He so upset calls for any helper to come forward. Finally, her Lisa Kay took a razor blade to her arm. Faith, a CIE, showed up. She told me that, since Wendy took over in time to stop Lisa Kay and she never had a body, she was not affected by the called the SPS. She told the worker what had sleeping pills, and she was the only one awake at been going on and was advised to scream loudly the time. She said that, in spite of their aversion in her room to make herself feel better. to hospitals, the only safe place where they could When I saw her next, I advised Sad Ma- recuperate was in one. Since she didn't know if rie, who detested Collins, to develop a plan of she could safely drive "them" to the hospital, I action the next time Collins showed up. I sug- filled out a 72-hour hold order and called for an gested she join with Joyce, an assertive al ambulance to take her to the Yolo General Hospi- ter-personality. Sad Marie would have the detest- tal seclusion room. ing feeling toward Collins, and Joyce would have This was the riskiest situation possible, the ability to tell him off in politely but force- since Faith, being a CIE and not an integral part fully. With the two of them working in concert, of Sad Marie's psychic system, could have left they might persuade Collins to stay away from her body any time she chose. But "The Creator" their home. In addition, I instructed her to call needed Sad Marie to survive, since she was need- Parker whenever Collins called and tell her about ed for important work in the future. the call. She could then deal with him in whatever Since birthdays are inevitable, Sad Marie manner she chose for violating the rules she set has finally learned how to handle them. She plans for him. I hoped that Parker would expel Collins the day carefully, three months in advance, and from the Satellite House for men, since he was schedules some exciting and different happening drinking in the house as well, another gross viola- each year on that date. She has gone bungee tion of their rules. jumping on three successive birthdays, and on *** two birthdays, she has had her portrait taken by a Birthdays were always traumatic. Not glamour studio photographer. Her latest extrava- only did this signify another year passing, and gance was spending a month at a health spa, another year to go, they also reminded Sad Marie where she could expect to be completely over- of how her father had raped her on her first birth- hauled. In this way birthdays are celebrated in- day. After that "celebration," she could never stead of feared, and over time she may even look again enjoy a birthday. forward to them. When Sad Marie's 30th birthday arrived ****** that Fall, she was ready to kill herself on that Sad Marie's experiences with the staff of day. One of the helpers had found the bottle of the Stepping Stones Day Treatment Service and pills she had hidden under the mattress and called with the Suicide Prevention Service occurred dur- the SPS again. That foiled the plot for that night. ing the same period of time and involved the The next morning, Veronica managed to same issues and themes. Both were seriously con- swallow a number of Sominex pills an hour be- cerned with keeping her from killing herself, a fore Sad Marie arrived at my office. By the time daily preoccupation of Sad Marie's. Obviously, she got there, she was almost asleep. The "angry the goal was reached, or this story would not psychic sisters" had not yet become sedated, and have been told, but that is all that is similar be- Veronica and Rehab fought with me while they tween their two approaches.
In the use of the services of the Day they might have missed in their training, they Treatment staff, I made several major tactical could have come to my educational sessions in errors. First, I should have called out Becky good conscience, since all professional staff and/or Faith to discuss this optional treatment members are expected to take continuing educa- program before making my referral. They were tion courses. That would have been my intent, not apprised of the situation they would then find had I considered the well being of my patient themselves in. They might have agreed, with pro- above my own. visos, but I never gave them a chance to check At the same time, the staff of Stepping out the staff or the other clients to determine if Stones could have admitted to the referring doc- they would be a good mix for their charge, whom tor that they did not know much about MPD. If they knew well. I made the referral because of they had admitted to me that they needed to learn certain assumptions I made, and I didn't check what I could teach them, and fast, I would have these assumptions out with them to learn if they had the opening I needed to bridge the gap that were accurate. existed. Being part of the same system, I wanted Had I asked Becky, I would have learned to assume that they knew what to do. They didn't that she had the suicidal threats under control at want to appear inadequate in anyone's eyes. the time and did not need to have Sad Marie Their need to hide their inadequacies monitored by mental health professionals. What Becky needed was to be able to use the day after each therapy session for her own teaching to Sad Marie, to give her time to solidify and clarify the lessons I had laid out for Sad Marie. Sad Marie did not need to be diverted to a program that was designed for chronic schizophrenics without so- cial skills, with a staff who showed little interest in learning about the mysteries of the mind of the multiple. Once I committed myself to the referral to Stepping Stones, I refused to meet and confer with Becky over what they would be doing to deal most effectively with the staff. Becky would have made it clear to me that the staff had no idea about the mental disorder of their new client, and she would have insisted that I set aside time to teach them at least what I had already taught the staffs at the private agencies in Sacramento. Her working relationship with me would have been strong enough to persuade me to put aside my political concerns that the staff members would have been insulted if I had implied they didn't know enough to treat this one patient with MPD. They didn't, but they were too embar- rassed to admit such ignorance. Had I presented the option that I could clue them in on items that
very important in her future growth and develop- ment, in a perverse sort of way. During her period of personality integra- tion, which coincided with her separation anxiety over her doctor planning to leave, she did have the human support she needed to cope with the intense feelings both of those events invoked. They did come to know her in ways they could not have if she only came to them in crises, which was the way she appeared to many other profes- sionals in the system. Sad Marie's experience with the volun- teers of the Yolo County Suicide Prevention Ser- vice was a much more positive one. Here, be- cause of my prior experience of training such volunteers for five years in Santa Cruz, I had no qualms about introducing myself to them and offering to train them about MPD, and Sad Ma- rie in particular. These people knew what they didn't know, and they were not ashamed to admit it. They were competent people in their own fields and had no egos to protect. They had no hidden agenda regarding either Sad Marie or me. They were simply there to help their fellow men and women in distress, and they were open to any ideas that might enable them to do that job better. When in doubt, they could call me at home, but, with the information I gave them and which they shared among themselves, they never needed to, after the first call. Their advice was "homey," but useful, and they always managed to say the right things at the times of call. Of course, it helped that Becky was simultaneously communing with the Essences of the volunteers, advising them what to say to her charge. The words might have sounded weird to an outside listener, but that was of no importance to the volunteers, who were there to say whatever would calm the caller down and get her moving in a more positive direction. They did what was needed to be done at a time when such human support was essential to Sad Marie. Without them, she very well might not have kept afloat until her day of integration arrived.