Brooklyn Zoo: The Education of a Psychotherapist

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Overview

A compelling memoir of a psychotherapist’s clinical and personal education amid chaos and dysfunction that delivers an emotional impact to rival Susan Sheehan’s classic Is There No Place on Earth for Me?

Seven years after her college graduation, Darcy Lockman abandoned a career in magazine journalism to become a psychologist. After four years in classrooms, she spent her final training year at the Kings County Hospital, an aging public ...

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Brooklyn Zoo: The Education of a Psychotherapist

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Overview

A compelling memoir of a psychotherapist’s clinical and personal education amid chaos and dysfunction that delivers an emotional impact to rival Susan Sheehan’s classic Is There No Place on Earth for Me?

Seven years after her college graduation, Darcy Lockman abandoned a career in magazine journalism to become a psychologist. After four years in classrooms, she spent her final training year at the Kings County Hospital, an aging public institution on the outskirts of Brooklyn. When she started, little did she know that the hospital’s behavioral health department—the infamous G Building, where the Son of Sam serial killer David Berkowitz and the rapper Ol’ Dirty Bastard once resided—was on the cusp of its darkest era yet, one that culminated in the death of a patient in a psychiatric emergency room described by the New York Post as a “Dickensian nightmare.”

Brooklyn Zoo unfolds amid the constant drama and disorder of the G Building. Lockman rotates through four departments, each of which presents new challenges and haunting cases. She works with forensic psychologists to evaluate offenders for fitness to stand trial—almost all of them with pathos-filled histories and little hope of rehabilitation. The thorny politics of the psych ER compound her anxiety about working with its volatile patients, but under the wing of a charismatic if brusque mentor she gains a deeper insight into her new profession as well as into her own strengths and limitations.

As she moves to the inpatient ward and then psychiatric consultation liaison, Lockman’s overstretched supervisors and the institutional preference for pills over therapy are persistent obstacles. But they eventually present a young clinician with the opportunity to reexamine everything she believes and to come out stronger on the other side.

Lockman’s frank portrayal of her fledgling role in a warped system is a professional coming-of-age story that will resonate with anyone who has fought to develop career mastery in a demanding environment. A stark portrait of the struggling public mental-health-care system, Brooklyn Zoo is also an homage to the doctors who remain committed to their patients in spite of institutional failures and to the patients who strive to get better with their help. And it is an inspiring first-hand account by a narrator who triumphs over self-doubt to believe in the rightness and efficacy of her chosen profession.

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Editorial Reviews

From Barnes & Noble

They say that all internships are baptisms in fire; Darcy Lockman's one-year training at Brooklyn's Kings County Hospital might be best described as a full immersion in hell. Tabloids had already gained circulation with exposes about dire conditions in the East Flatbush health center; only shortly later, it was revealed that a full one third of all New York hospital malpractice suits originated at the beleaguered hospital. For the young psychologist and freelance writer, her labors in the ER and elsewhere were equal parts occupational revelations and disillusionments. Her memoir captures the chaotic realities of a big city hospital that most of us glimpse only fleetingly in moments of personal crisis.

Publishers Weekly
Clinical psychologist and journalist Lockman writes about her intern year at Brooklyn’s Kings County Hospital, detailing her rotations in forensic psychology, the psych. emergency room, an inpatient unit, and as a “consultation liaison” with medical staff. She captures the hopeless dreariness of the place—the inpatient unit is “a large stale-smelling place with... cold white concrete floors and rusty-paned windows that did not open.” Above all, Lockman illustrates how difficult it is to engage patients with serious psychiatric illnesses. She asks one patient about her sleep and appetite—possible signs of mental disorder—and the patient responds, “You’re a nosy one, aren’t you?” Lockman is candid about her frustrations (and all too occasional small triumphs) with patients, as well as with absent or burned-out supervisors. She says that psychological insights were often trumped by psychiatry’s biomedical model. Although crisply written, there are too many brief interactions with too many patients, perhaps reflecting the nature of the work. Exemplified by a reference to “my masochistic defenses,” she sometimes alludes to her own psychological dynamics without adequately explaining her personal interactions. Still, this is a useful, sometimes memorable, look at the vagaries of a psychologist’s training and role in an overwhelming institutional setting. Agent: Dan Conaway, Writers House. (July)
From the Publisher
Advance Praise for Brooklyn Zoo

“‘Abandon Hope, All Ye Who Enter Here’ might well be the words above the door of Kings County Hospital’s notorious G Building.  Serial killer Son of Sam and rap legend Ol’ Dirty Bastard punched their tickets at this under-funded, over-crowded mental hospital; so does Darcy Lockman, a wet-behind-the-ears psych intern fresh out of graduate school. She can empathize with the human flotsam washed up on the outer edge of outer Brooklyn—the white folks get sent to Bellevue, in Manhattan—but more to the point, she can write. Brooklyn Zoo is a sorrowful and fascinating portrait of the institutional underworld where criminality and mental illness co-exist, and patients find themselves at the mercy of a medical-penal complex ill-equipped to either cure or punish them.”
—Alex Beam, author of Gracefully Insane: Life and Death Inside America’s Premier Mental Hospital

“Reading Brooklyn Zoo is like getting a nightly e-mail from your best friend as she explores the far side of the moon.  I gasped at what she saw and alternately winced and cheered at her responses.  A smart, delightful surprise of a book.”
—Susan Baur, author of The Dinosaur Man: Tales of Madness and Enchantment from the Back Ward

Brooklyn Zoo takes us to places where very, very few of us would ever go—or want to go. This interesting memoir deals with situations which might be considered hopeless with great compassion and clarity. For so many of these people, mental illness is the least of their worries but the most of their handicaps. An insight therapist is at a huge disadvantage, and Lockman feels it deeply. She cares about people in a way that few of us dare.”
—Joanne Greenberg, author of I Never Promised You a Rose Garden

 
"A former journalist, Lockman delivers fascinating revelations.... [A] good story."—Melissa Maerz, Entertainment Weekly

"Darcy Lockman left her journalism career to become a psychotherapist. Clearly a gifted writer, the decision could not have been easy. But she made it and stuck with it.... Brooklyn Zoo, to be released in July 2012, is expertly written: The prose flows, the pacing is even, and the structure is well crafted. As well, the content—the story—is utterly fascinating.... It is...an intelligently written, sobering look at what it takes to be a psychotherapist.... It’s the kind of book you don’t want to rush through; you want to dwell on each chapter, and meditate on Lockman’s experiences to get a fuller sense of what she saw. With a unique voice and a knack for painting verbal portraits, Lockman has delivered a rare gem."—Dan Berkowitz, Psych Central

"The challenges facing a psychotherapist during a yearlong internship in a New York City public hospital.

Based on her own positive experience in psychoanalysis, Lockman pursued an education in the psychoanalytic tradition, which included supervised therapy with clients, one of whom she saw over a three-year period. She explains that this put her at odds with the mainstream of the profession today because of “the pernicious hostility toward the psychoanalytical way of working,” which often dismisses psychological problems as “nothing more than chemical occurrences in the brain.” She chronicles her initial frustration with her inability to put her education and skills to good use and her dawning understanding that the chaotic conditions at the hospital often made her skills irrelevant anyway. Her patients constantly struggled with the brutal conditions of inner-city life, job loss, random violence and more. The author eventually realized that the most important gift she could give them was her willingness to listen to their concerns and treat them with respect, while evaluating whether they should be released or sent to long-term care...

Before returning to graduate school Lockman worked as a magazine journalist, a skill she puts to good use in this insider's look at the practice of psychiatry in a poorly funded, understaffed public institution."—Kirkus

Library Journal
In 2007, psychologist and freelance magazine writer Lockman began her yearlong internship at Kings County Hospital in Brooklyn, barely a month after the New York Post broke a story about the hospital's "Dickensian" conditions. In this debut memoir about her training there, she marvels at the counterintuitive practices in place in the G Building, Kings's inpatient adult psychiatric center, where a lack of supervision, resources, and even working elevator call buttons are a matter of course. Readers follow Lockman's rotations through inpatient, psych ER, forensic psychology, and consultation-liaison psychiatry. Though lively details do emerge—a female patient, hiding in a restroom garbage pail, terrifies a male patient who sees "her intense little eyes peering over the top"—Lockman's tone is grudging. She's more animated when railing against the hospital's "strong ambivalence about psychology," psychoanalysis in particular, than its "culture of offhand neglect." VERDICT Neither a moving personal history nor a crusading insider's look into a broken system, Lockman's book lacks that certain storyteller's spark. In the end, her patients spin better tales.—Molly McArdle, Library Journal
Kirkus Reviews
The challenges facing a psychotherapist during a yearlong internship in a New York City public hospital. Based on her own positive experience in psychoanalysis, Lockman pursued an education in the psychoanalytic tradition, which included supervised therapy with clients, one of whom she saw over a three-year period. She explains that this put her at odds with the mainstream of the profession today because of "the pernicious hostility toward the psychoanalytical way of working," which often dismisses psychological problems as "nothing more than chemical occurrences in the brain." She chronicles her initial frustration with her inability to put her education and skills to good use and her dawning understanding that the chaotic conditions at the hospital often made her skills irrelevant anyway. Her patients constantly struggled with the brutal conditions of inner-city life, job loss, random violence and more. The author eventually realized that the most important gift she could give them was her willingness to listen to their concerns and treat them with respect, while evaluating whether they should be released or sent to long-term care. Her internship included forensics (the determination of whether a prisoner was mentally fit to stand trial), different stages in the intake procedure, and consultations with doctors treating medical patients who seemed disturbed. Lockman remains convinced that along with the socioeconomic problems that place limitations on the treatment offered to mental patients in public hospitals, the medicalization of mental illness is also at fault. Before returning to graduate school Lockman worked as a magazine journalist, a skill she puts to good use in this insider's look at the practice of psychiatry in a poorly funded, understaffed public institution.
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Product Details

  • ISBN-13: 9780385534284
  • Publisher: Knopf Doubleday Publishing Group
  • Publication date: 7/17/2012
  • Pages: 320
  • Sales rank: 1,433,810
  • Product dimensions: 5.88 (w) x 8.36 (h) x 1.16 (d)

Meet the Author

Darcy Lockman, Ph.D., is a clinical psychologist in private practice in New York City. She received her Ph.D. at the Derner Institute of Advanced Psychological Studies at Adelphi University. Her writing has appeared in the New York Times, Psychology Today, and Rolling Stone, among other publications. She lives with her family in Queens.

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Read an Excerpt

Chapter One

My relationship with psychology began when I was eight. My mother started seeing a therapist she called Sylvia, and soon enough my father began going, too, after—as he would tell me many years later—my mom suggested the problems he was having in their marriage were not solely about her. What my mother meant was that my father was reexperiencing old feelings from his earliest formative relationship in the context of a new and different one. In other words, he felt treated by his wife how he'd felt treated by his mother. No one who knew my grandmother Mina (who openly derided every gift she'd ever gotten and had once shown up at my parents' apartment with just-purchased underwear for her newlywed son) could have imagined my father's old feelings to be benevolent. So my parents embarked on separate journeys of self-understanding, which I inferred allowed them to remain together. It was 1981, and we lived in the western suburbs of Detroit. Ronald Reagan had just become the country's first divorced president, and many of the fathers on our street were moving on. That therapy had facilitated my family's escape from the hovering menace of dissolution was no small thing to me.

And so I became curious about psychotherapy, but I never asked my parents to describe it. Like all of the adult concerns that evoked pointed interest in me, it seemed illicit. I also wanted badly to discourage all open discussion of their latest pastime, lest they feel comfortable enough to mention it in front of my friends, whose families I vehemently believed had stepped straight off the soundstages of the late-1950s sitcoms I'd seen in reruns. That my parents went to therapy became one more dreary secret that I added to a list, though what I was really most desperate to keep under wraps was how much they disliked me. Were others to know, they could only reject me as well.

Not long after they started seeing Sylvia, my mother went back to school to become a social worker, a therapist herself. I was in the fourth grade and my sister in kindergarten, and though my mom had once been a teacher, she'd been at home, more or less, since I was born. After her graduation from social work school, she started seeing patients, and like anyone else she would talk about her work. Her stories were more anecdotes than case presentations, but I didn't know enough to distinguish between the two. By the time I got to college, I assumed psych classes could only be superfluous, and I refused to sign up for any, defying all expectations of my gender and ethnicity. But also, as determined as I was at eighteen and twenty and even twenty-five to be sublimely unlike my mother, it never crossed my mind that I would become a therapist. I thought I'd be a lawyer—like my father.

It did occur to me to become a patient. The first time was my senior year of college after my mom suggested it. She thought I was "too anxious," a pronouncement I felt she might have delivered in any number of gentler ways, but still I considered it. She had colleagues near my campus in Ann Arbor, and she gave me a number. I called and got an answering machine but could not think of a thing to say. The second time was a couple of years later. I had finished undergrad and moved to New York to take an internship at a rock-and-roll magazine, but more to the point to live somewhere exciting. If things were going fine on paper, I often felt rotten. I couldn't make any sense of myself. One lesson I had learned from half-listened-to conversations from my adolescence was that there were a lot of bad therapists out there, and so I got another referral, from a friend of my mother's who knew a psychologist in Manhattan. I made an appointment but showed up on the wrong day, leaving Dr. Aronoff's office in angry tears when nobody answered the buzzer. As I walked south on Fifth Avenue along the park on the way back to the entertainment magazine where I had by then become an editorial assistant, I thought, "I am trying so hard and still cannot get any help," a masochist's mantra.

Years later I would learn from the therapist's side of the experience that the way in which a patient begins the therapy relationship is a proclamation of sorts—a snapshot of what he or she is struggling with—and I sometimes thought back on the way I began my own treatment. When I called Dr. Aronoff after that first afternoon to tell her that I'd traveled all the way from midtown at her behest just to find her absent, I was demonstrating this expectation: I would be the victim here and she my giddy torturer. "I teach on that day," I remember her responding kindly. "I don't think I would have scheduled an appointment then." Look now, she was alerting me, we have some other options.

What relieved me most in those first years with Dr. Aronoff was a nascent appreciation for my own internal consistency. Where my feelings had once seemed arbitrary and free-floating as particles of dust, it was now clear that they related to one another and also to the entire span of my backstory. As I had grown up fed and clothed and never so much as smacked on the bottom, it was easy to maintain a dogged belief that everything had been fine. It hadn't felt fine, but I'd learned to ignore that—hands over my ears as I hummed—because certainly that was my fault, a confirmation of my innate and immutable decrepitude. Only slowly and with Dr. Aronoff's listening could I begin to know more about my old feelings and the imprint those feelings had left.

I'd been lucky enough to stumble into therapy, and so slowly—how lucky I was—I began to see that the things that were most distressing as I moved through my young adulthood barely existed outside my head. It cannot be underrated, that ability to distinguish between outside and in. Left and right I was distorting external realities to make them match my earliest internal ones, or involving myself with people who confirmed old and sorry expectations, or unconsciously cajoling others into buttressing my most unpleasant fears. Neurotic misery, Freud called it. Condemning the future to death so it can match the past, the singer-songwriter Aimee Mann called it. Dr. Aronoff, influenced primarily by the Freud protegee Melanie Klein, called it clinging to the bad breast. Over and over together we found evidence of this insistent grasp. With time I understood that the way I had come to see the world, my place in it, was more about perspective than any absolute reality, and if that was true, at least many more things were possible. I had never been religious, but for the first time in those years I knew what it felt like to believe absolutely in something intangible, to have faith, though Dr. Aronoff made no claims of divinely sanctioned insight. It was simply an education, allied to a temperament more patient than my own, that had allowed her to bestow her gifts. To be able to offer others what she had given me, some freedom from old bad feeling, I just had to go to school, nothing I hadn't done before.

In terms of formal education, several options were available to me on the road to becoming a psychotherapist. The simplest, because of its relative brevity, would have been social work school, but having spent many years listening to my mother lament that social workers got no respect (another masochist's mantra), I was not about to sign up for that. The most lucrative was likely to be medical school, which would set me up to become a psychiatrist, but psychiatrists were no longer necessarily trained in talk therapy: instead, they prescribed pills. I had nothing against medication, but I did not find it interesting in any but the most cursory way. A doctoral program in psychology—comprising four years of theoretical course work and concurrent talk therapy with actual patients, followed by a yearlong clinical internship—seemed like the obvious choice. Dr. Aronoff was neutral but supportive. I half wished for her to tell me she thought I would be good at what she did, but I was well schooled enough by then in the ways of therapy to know we would only examine this desire. For her to explicitly say so would have felt superficial in the context of our relationship anyway, and also less powerful than the fact that in my heart I believed she felt it, as she had for many years been my stalwart teacher.

The first patient I ever saw in therapy had a problem with a kitten. A nineteen-year-old undergraduate at the same university where I was by then in the second year of my doctoral training, she had recently adopted this kitten and had found herself faced with the terrifying realization that she was not responsible enough to care for the animal. She was distraught, really in a panic. Could she simply return it, she wondered, or was it destined to become a victim of her reprehensible immaturity? "He would be so much better off with somebody else," my patient told me with fierce passion as tears stained her translucent skin.

I don't remember how the issue was resolved, if the kitten stayed or went. What I do recall vividly is that my patient and the young cat had some striking autobiographical similarities. Like her pet, my patient had been stuck with a nineteen-year-old single mother, one too irresponsible to parent her to boot. My patient had silently endured her mother's unpreparedness, waiting for what had felt like lifetimes in front of schools or friends' houses for a woman who'd promised earlier that day to pick her up, or in bed for her mother, who she always feared dead, to relieve yet another late-night babysitter. To cope, my patient, like every child before her, honed psychological defenses: ways one protects oneself from anxiety and grief and injuries to self-esteem. She spent many hours lining up her dolls—not playing, just arranging.

While I listened to my patient lament for her poor cat, I knew for certain that she was re-creating an earlier emotional experience of her own, trying the whole scenario out on the kitten to see what would happen. Psychologists call this particularly creative defense "acting out"—replaying once terrifying situations to transform old feelings of vulnerability into experiences of power. Acting out is driven by the unconscious need to master anxiety associated with old and powerfully upsetting fears. We act out what we cannot allow ourselves to remember, and usually even once we've remembered, we forget again and do the whole thing over. Psychologists call this forgetting "repression," the doing over "working through." When viewed from a therapist's chair, it's rather like watching a play in which the star is also writer and director for an unsuspecting supporting cast. By the time I'd met my first patient and heard about her cat, I had read papers on "the repetition compulsion" and "core conflictual relationship themes" and so on and so forth, but I also knew firsthand what it was like to feel so unconsciously compelled to repeat. My own mother's explosiveness had early on left me with two rotten choices: either she was very crazy, or I was very bad. A fair portion of my early adulthood was spent trying to work out which it was, and to that end I befriended more than a couple of high-strung girls, each of whom I grew close to and then finally cut off abruptly, exclaiming "She's crazy!" to anyone who had patience enough to listen. Dr. Aronoff finally asked whom I actually thought I was trying to get rid of.

"When you listen to yourself talk about this cat, does it remind you of anything?" I asked my patient cryptically in our early days together. Of course it did not. It was too soon. She was not yet ready to know. Later, as invariably happens, she would re-create an aspect of her childhood dilemma with me, regularly missing sessions as I waited bereft in my office, longing for her to appear just as she'd once ached for her mom. A good therapist uses her own emotional reactions to help the patient put her early experience into words, but I wasn't there yet.

"The unconscious doesn't know who is abandoning whom," one supervisor said to me, explaining that my patient was likely feeling left by me, even though she was the one who was not showing up.

"If she had come regularly and had experienced you as a consistent part of her life, she would have had to grieve all that she didn't have as a child," one of my professors commented in my final weeks of school when I presented the case—which had by that time spanned three years.

I saw many clinic patients during my four years in graduate school. They arrived with their problems and their stories, and because I was being educated in the psychoanalytic tradition, I learned to begin by asking myself two questions. First, what was their developmental level? At what point in their emotional development had things begun to go awry—the earlier it had been, the worse off they were. Second, what was their character organization? In what ways did they tend to distort reality in an attempt to feel less pain? Together these answers provided an important if gross starting point for every treatment. A patient's developmental level was psychotic, borderline, or neurotic; his character organization within that level masochistic or obsessive or narcissistic or depressive—the list goes on some—depending on the constellation of defenses he tended to favor. (Myself, I was neurotic, and my own character style a tinge masochistic with stronger undercurrents of depressive: having felt from quite a young age that painful experiences with my parents were my fault, I believed I was so bad. I was not unlike other psychotherapists in that regard. What better way to alleviate a constant and nebulous sense of guilt than to devote one's life to helping others?)

These two dimensions shed light on the patient's internal experience, on how he organized and perceived his life. What had become more popular in the world at large, under the rubric of cognitive-behavioral therapy, or CBT, was an emphasis on discrete symptoms, say social phobia or panic attacks, that could supposedly be alleviated in short, rote bursts of ten sessions or fewer. At my school patients came to us for long-term work and character change, to alleviate troubling thoughts and behaviors and then some, as true well-being is more than just the absence of symptoms.

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Sort by: Showing all of 5 Customer Reviews
  • Posted September 5, 2012

    Interesting

    A very interesting and somewhat depressing book. So many broken people, patients and physicians alike. What a horror the politics in the health care industry are. Poor patients. Having mental health problems is horrifying and I have to admire the people who genuinely care and are really trying to help people recover. What a daunting task. The differences in the author's year experience and her husband's in a different facility are so poles apart it doesn't seem they are in the same health care field. I enjoy true medical stories told from the docotor's perspective, so was glad I read this, but it is a bit of a hard read.

    2 out of 2 people found this review helpful.

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  • Anonymous

    Posted June 11, 2013

    Disappointing. Has several main threads--psychology vs. psychia

    Disappointing. Has several main threads--psychology vs. psychiatry, coming of professional age, exposé, workplace/bureaucratic infighting, the cases of her patients--but does not do an adequate job with any of them. Some aspects (her coming of professional age, e.g.) are dealt with better than others, while some are downright desultory (poor hospital vs. adequately funded hospital). Interesting moments, but sometimes flat, sometimes naïve; the book really doesn't come fully to grips with any of the worthy themes she introduces.

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  • Anonymous

    Posted August 12, 2012

    Vividly written, intelligently researched, totally absorbing!

    Vividly written, intelligently researched, totally absorbing!

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  • Anonymous

    Posted July 31, 2012

    No whining!

    So far this book is an unrelenting whine about the internal politics and petty annoyances of any workplace. I may not be able to finish this book. Nothing with any insight or even slight interest about the patients or her therapeutic work with them,if there was any.

    0 out of 1 people found this review helpful.

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  • Anonymous

    Posted July 21, 2012

    No text was provided for this review.

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