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The second challenge to sanity takes place during clinical supervision. Delving into someone else’s subconscious can be quite perilous if you cannot separate the patient’s pathology from your own. At least that was the rationale given for the relentless examination of my reactions to clinical material. "I noticed that you arrived late today," my supervisor would say, "Does this have anything to do with your difficulty in accepting authority?" As a rule, most clinical supervisors find it easier to interpret your comments rather than respond to them.
Then there is the daily exposure to severe maladjustment. The spectrum of psychopathology is as dynamic as it is challenging. For some, Human nature provides the creative impetus for music, art, and poetry. It is quite simply a job for the clinical psychologist. A similar process is experienced by policemen who adopt a dismal perception of the world that is based upon crime and punishment, or firemen who notice subtle safety infringements while out with the family for dinner. Fleeing from threat, danger, or bizarreness may be considered a natural reaction among normal people. But the clinical psychologist tries to engage, to confront, and to contain. In time one develops a defensive barrier, in the form of professionalism, which helps maintain the vital boundaries needed for self-preservation.
It is the banal, and sometimes ridiculous, reactions of others at cocktail parties that set the psychologist apart from normal people. "So, what am I thinking?" someone might challenge – assuming that I had the extrasensory powers of a telepathic medium. Or they might call a friend over and teasingly joke, "Here’s someone you gotta meet. He needs a shrink." Over the years I have developed a fund of reactions to these embarrassing situations. There are funny responses, mischievous ones, and serious ones – depending on my mood. For instance, a not uncommon question is, "What is the difference between a psychologist and a psychiatrist?" to which I might say, "Oh, about 40 bucks an hour," if I wanted to be funny.
The question that I hate the most is, "So, what made you become a Shrink?" It is asked in the same manner that one might wonder why someone was a vegetarian. My response is either non-committal, evasive, or funny. Failing this I ask, "So, why is that question so important to you?" in a classical analytical tone of voice, as Freud would have responded. Invariably the topic is changed.
Don’t get me wrong. I like being a Shrink. No day is like the previous one. The complexities of Human Nature continue to fascinate me. I get a great sense of satisfaction from managing to identify the underlying issues that drive people to behave illogically. Manoeuvring through the rigid defences of a paranoid schizophrenic can be as exciting as playing chess. Encouraging someone bent on suicide to re-engage in life is rewarding. Every day presents a new challenge.
Over the years I have managed to build up a robust private practice in a plush tree-lined suburban neighbourhood. My office has a large green leather sofa and matching armchair, where I usually sit. A tropical fish tank stands between two large windows that face the East. Books that line the walls are not just for show. A large flat screen computer monitor sits on my antique oak desk in a corner, which is lit with expensive china-based table lamps.
Looking around me I can understand why others consider me ‘established’. Indeed, things worked out well, considering. Few would guess how far I had come. No one has any idea that my career began in the slums of the Bronx. What would they say if they knew about the gang life, the crime, and the poverty? They certainly won’t understand why I did what I did, back in 1969, unless they heard the whole story.