Brooklyn Zoo: The Education of a Psychotherapist

Brooklyn Zoo: The Education of a Psychotherapist

by Darcy Lockman

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Overview

In her eye-opening, ruthlessly honest account, Darcy Lockman shares the stress, frustratation, and exhilaration of her clinical training as a psychologist in the midst of institutional dysfunction at Brooklyn’s Kings County Hospital.
 
After leaving her career in magazine journalism to become a psychotherapist, Darcy Lockman confronted a slew of challenges including numerous troubling cases, struggles to provide the poor and chronically ill with adequate care, and the general and sometimes humorous indignities of being a trainee in any field. This compelling memoir will by turns deeply move, shock, and enrage you. Hope is not lost though, and Brooklyn Zoo introduces us to the many smart people currently trying to fix the mental health-care system, enhancing our understanding of what psychologists can make possible through their work.

Product Details

ISBN-13: 9780307742520
Publisher: Knopf Doubleday Publishing Group
Publication date: 04/09/2013
Pages: 320
Sales rank: 809,772
Product dimensions: 5.34(w) x 7.86(h) x 0.73(d)

About the Author

Darcy Lockman, Ph.D., is a clinical psychologist in private practice in New York City. Her writing has appeared in The New York Times, Psychology Today, and Rolling Stone, among others. She lives with her husband and baby daughter in Queens.

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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Brooklyn Zoo: The Education of a Psychotherapist 3.3 out of 5 based on 0 ratings. 9 reviews.
SmokeDancer More than 1 year ago
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.
vasquirrel on LibraryThing More than 1 year ago
Lockman can write. She was a successful magazine journalist. That part she¿s got covered. But, a psychotherapist?She chose to do her intern year at Brooklyn¿s Kings County Hospital. WHY? Her fiance interns at prestigious Columbia-Presbyterian. I was forced to conclude that she¿s either masochistic or not too bright or BOTH. Her experience (as she tells it) is one depressing moment after another. Her supervisors are half-assed, the facilty is nasty (AND under federal investigation), the focus is NOT on therapy, and psychiatry trumps psychology every day. Lockman over thinks EVERYTHING and UNDER-shares what would really be interesting. She thanks her parents for being ¿undisguised subjects in their daughter¿s memoir¿ but barely touches on what she implies is a difficult relationship with her mother. What about her fiance? How are they handling their very different clinical experiences? She touches on her own therapy, but WHAT has she learned about herself?Competent writing ¿ boring content.
bobbieharv on LibraryThing More than 1 year ago
To me, this memoir was like a travelogue: first we did this, then we did that, then there was that ... We went from one patient to the next, descriptively but not reflectively. Then, all of a sudden on page 228: "Vera and I had some things in common, personality-wise. My masochistic defenses - superimposed like paper doll dresses over the depressive ones - had loosened over time in therapy, but I'd gotten to know them well there ..."Now this is interesting, especially to a psyche major as I was. But it came as a shock: masochistic defenses papered over depressive ones? Haven't seen any of this so far in the book. And why did it take 200 pages for a glimpse of Lockman's own personality, her own hangups? And then, toward the end of the book, there's her review with Scott where she finds out everyone dislikes her. Why? She's told us about her dislike of Caitlin, and of her refusal to feed Scott's narcissism, but again we're told, not shown. I wanted more about her, and a lot fewer cursory descriptions of each patient and each event. I wanted to know how her interactions with patients and staff affected her, changed her, made her more aware. I wanted to see, woven through these interactions, exactly how her masochistic defenses masked her depressive ones. And (though maybe this is too much to ask of a so-called "career memoir") I would have loved more about her relationship with her fiancee George, the Ivy-league psychotherapist. All in all, mildly interesting but kind of a slog by the end.
meggyweg on LibraryThing More than 1 year ago
An excellent career memoir. Darcy Lockman notes that years in graduate school taught her how to be a scholar, but not how to be a therapist. For her training in that area she went through a grueling year-long internship, rotating through various fields of psychotherapy and meeting all the manner of wretched people. A psychoanalytically trained therapist accustomed to working with the relatively healthy, for her, seeing the people in forensic psychology, inpatient settings, etc., was a real eye-opener.As she learns about what really goes on, so does the reader. I had read a lot of books about psychology and psychotherapy before, as well as having been in therapy myself for years, but I still learned a lot from this book. You also saw Darcy grow as a person during her training year, until by the end of it she had become much more confident and less self-critical. Also noteworthy was how she was able to make unique characters out of her co-workers and supervisors, when a lesser writer would have let them all blur together.Altogether, quite a prize of a book. I read it in one sitting.
fanoftheoffice on LibraryThing More than 1 year ago
I thought this book was very well-written, interesting, and even humorous at times. However, I am a psychologist so I am having some difficulty reviewing the book and it's contents alone. I feel compelled to comment on her experiences as well. I completed my internship 8 years ago, and it was also at a psychiatric hospital. I had a great experience because I love working with persons with serious mental illness. I knew the hospital would be a good fit for me, and the people who supervised my internship knew I would be a good fit for them. Darcy Lockman was a terrible fit for a psychiatric hospital and everyone should have known that at the time of her interview. Internship is the time when a person really focuses and trains intensely in the area in which they intend to practice. A person who is psychoanalytically trained should not work in a hospital. Period. Persons with a serious mental illness cannot meaningfully participate in psychoanalysis, as anyone could tell from reading this book. Ms. Lockman was at a total loss for how to handle people who are not high functioning, and she didn't really seem totally interested in learning this skill either. This may be why her supervisors consistently gave her low ratings. You could tell that her supervisors thought she should have come into this experience with more training in this area, and they seemed constantly exasperated with her lack of knowledge. Overall, the book was a good read, but it was quite difficult not to get frustrated at the idea that she took an internship spot from someone who really could have used it more meaningfully.
Anonymous More than 1 year ago
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.
Anonymous More than 1 year ago
Vividly written, intelligently researched, totally absorbing!
Anonymous More than 1 year ago
Anonymous More than 1 year ago
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.