We have this idea of what therapy is supposed to look like. There's a couch. An objective therapist sitting across the room scribbling notes. But of course it's not that simple. What happens when your therapist is not really a therapist? Or the therapist is the one in tears? And of course, should you or should you not, try to have sex with your therapist? In this episode, six short stories, many from our listeners, looking at how the role of patient and therapist can get... complicated. Our stories are courtesy of: Shaunacy Ferro is a senior staff writer at Mental Floss. Michael Heintzman is a writer and actor. Jerry The Series is his latest project. Steven Puente first told his story on Story Collider. Michael Stahl is a writer, editor and journalist. His story was first published in Narratively. And listeners like you. Thanks to Dr. Jeffrey Younggren for his thoughts and wisdom on ethics in patient/therapist relationships, and to Gary Schoener for his expertise on Dr. Renatus Hartogs. A therapist's office is usually a private space, a place to share secrets. We don't often get the chance to see inside. So with many New York City therapists taking the month of August off, we invite you inside half a dozen or so therapeutic spaces. Make yourself comfortable, take your time and have a look around. - Amy Pearl, WNYC photographer (Amy Pearl/WNYC) Blair Casdin, psychotherapist, LCSW-R New York, NY Everything in a session has meaning, and the office is no different. The furniture, the lighting, the books, even the flowers. Recently, I purchased a water pitcher. One client joked that the water filter is toxic. Was he suggesting that what I have to offer him is toxic? The next week, however, he allowed himself to take a drink. For another one of my clients, the sight of the pitcher provokes a thirst she cannot quench. She fills her cup throughout the session, and admits that she never feels satiated. Most of all, I think a therapy office should be a place of comfort, opening a space that allows for open and engaged and even new thought, for both of us. Maybe what I am going for is that feeling you have when you get home after a long day and can finally relax and put your feet up. (Amy Pearl/WNYC) Ali Mattu, clinical psychologist, Ph.D. New York, NY I want my patients to find something in my office that they can connect with, something that makes them feel at home. I scatter characters who have faced their fears, grown from their setbacks, and demonstrated resilience in the face of adversity. This stuff doesn't make Cognitive Behavioral Therapy any easier, but it does help the people I work with begin their own hero's journey. (Amy Pearl/WNYC) Stephanie Newman, psychoanalyst and psychotherapist, Ph.D. New York, NY I have practiced analytic psychotherapy and psychoanalysis in NYC for approximately 20 years. I'm the author of Madmen on the Couch: Analyzing the Minds of the Men and Women of the Hit TV Show. I am sure it will not surprise you to learn that reactions to the therapist's space are as diverse and varied as the individuals who offer them. For some, the chair, consulting room, objects I have displayed have become a sort of touchstone. I will elaborate: I recently moved to a new office after working for many years at another location. Once I was situated in the new place, many people shared their reactions. They noticed that things had been moved around to reflect the new office and layout but were generally glad to have their favorites, their touchstones. One common reaction (I paraphrase): 'The space is larger but the chair is the same as always.' Plus ça change, plus c'est la même chose! Ultimately it is about the alliance, the relationship, and the bond you and the patient form, that which is shaped by the constant presence and steadfast attention over many hours and minutes and seconds, spent in the room with a caring and attentive therapist and hardworking patient. (Amy Pearl/WNYC) Howard Danelowitz, Imago couples therapist, LCSW New York, NY The office was actually built for my colleague and for me and I wanted to try to have it be as open as possible. It's a little bit unexpected because when you walk into the very small waiting room you might expect something like that but there's actually a lot of light here and I feel a nice breeze. People feel comfortable with symmetry so you can keep on seeing symmetry in the room with two chairs, two doors, two rows of paintings. Every once and a while, someone will come in and say, 'I noticed your name on the paintings [in the waiting room]' and I will just ask them, 'How is that for you to know that those are my paintings?' I want to get a sense of what it means to them and if we have to talk about it further. I have felt lucky to have this as an office because I've seen many offices and a lot of them aren't special the way this is. (Amy Pearl/WNYC) Kate Dvorkin, psychologist, Psy.D. New York, NY When people walk in they are comfortable, that's the main thing. A lot of people find the couch very comfortable, people like at least some of the artwork. They walk in and they feel at ease because there are a lot of things to look at. The art work is varied, but it just has a nice feel; it's eclectic but comfortable — kind of like me! I created a space that I was comfortable in. A lot of people walk in here and say, 'This is a place I can work in and feel relaxed in.' Just being relaxed and comfortable is what I'm aiming for so people can focus on what they need to focus on. The space shouldn't distract you, you should be able to focus on yourself and your work. (Amy Pearl/WNYC) Owen Muir, psychiatrist, MD Brooklyn, NY I practice mentalization-based treatment and Interpersonal Social Rhythms Therapy (for bipolar disorder only). No other modalities by me. Only these two evidence-based treatments. The space is hip, open, has daylight (for IPSRT that is helpful), encourages thinking about music and art (in Williamsburg my patients are artists much of the time) and is a bit more off-kilter and less straight-laced than many other treatment spaces. I also have a prominent whiteboard for learning together. The space was designed with the help of psychologist and interior designer Paula Madrid, who helped with all aspects of the setup: furniture selection, flow of the room. Dr. MacMillan made sure that even the pillows convey the right message. And there are fidget toys for patients with ADHD to fiddle with! The photography is by Angela Cappetta, a New York photographer.
Earlier this year, North Carolina passed HB2, the so-called "bathroom bill." The law bans anyone from using a public restroom that doesn't match up with his/her biological sex. HB2 put the state in the middle of a national fight about gender. But North Carolina is also home to one of the few gender clinics for kids in the South, at Duke University's Children's Hospital. This week, we spend a day in that gender clinic, the only one in North Carolina. We wanted to know how a clinic like this one operates in this political climate. And we wanted to find out how these patients are coping. Dr. Deanna Adkins, a pediatric endocrinologist, started the clinic a year ago. Over the course of our day, we met three of her very different patients. Drew Adams is a 15-year-old trans man who came with his mom, Erica, all the way from Jacksonville, Florida. On the drive up, Drew wore a T-shirt with "This is What Trans Looks Like" printed on it. He told us he decided to change out of it before he stopped for a bathroom break in North Carolina; he used the men's room. When Dr. Adkins told Drew that not only would he get a prescription for testosterone, but that he could give himself his first shot that very day, Drew stood up and cheered. Dr. Deanna Adkins, the pediatric endocrinologist in charge of the Duke Child and Adolescent Gender Care Clinic (Mary Harris) We also shadowed Dr. Adkins's appointment with Jaye, an 18-year-old African-American trans woman. Jaye's experience has been very different from Drew's; her family has had a harder time accepting her transition. She also worries a lot about her safety, especially in North Carolina, and she can tick off the names of a number of trans women of color who have been killed over the last few years. But, like Drew, Jaye was thrilled when Dr. Adkins handed her a prescription for estrogen. She planned to pick it up that day. At the end of the day, we met Dr. Adkins's last patient, Martin, and his mom, Karen (we decided to use pseudonyms for them both). Martin was born a girl and came out as trans a year and a half ago, after a long struggle with depression and anxiety. At first, his mom worried that this was one more expression of Martin's unhappiness. But Martin's transition has completely changed his outlook. His mom said he used to be withdrawn; when his depression was at its lowest point, he started cutting himself and had to be hospitalized. Now, she says, "It's more like we've become friends again and we've reconnected. I think it's because he realizes that I accept him for who he is and I'm going to support him." This fall, Martin plans to present as a boy when he returns to school in Raleigh. When we asked him which bathroom he'll use, he told us it will depend how brave he's feeling.
When Robert Hoge was born in Brisbane, Australia, in 1973, his mother immediately knew there was something wrong. Instead of asking the doctors, "Is it a boy or a girl?" she asked, "Is my baby okay?" He wasn't. He had a tumor the size of his newborn fist smack in the middle of his face. His legs were very short; his feet were missing toes and twisted out of shape. Robert had surgery to remove the tumor, but it left him with severe deformities. At first, his mother didn't want to take him home from the hospital. She had four older children; she worried about Robert's impact on them. Eventually, she relented. She hoped to give her son a normal life. But Robert's life has been anything but normal. This week, Only Human spends some time with Robert Hoge. By all accounts, he's been wildly successful: he was the first in his family to go to college. He became a journalist, then a spokesperson for an Australian politician. He even carried the Olympic Torch before the Summer Games in Sydney. Hoge, now 44 years-old, had multiple surgeries to change his face, but eventually said enough. (Matt Warrell) But Robert's also had to get used to people calling him "ugly." And he knows better than anyone that there's this lie we all tell ourselves: that it's what on the inside that counts, and looks don't matter. So what do you do when the way you look forces you to confront that, every day? And even if you can get past it — what about the rest of us?
You've probably heard that laughter is the best medicine. This week, we set out to see if there's any truth to this idea. First, our host Mary Harris went with Kurt Andersen, the host of Studio 360, to try something called laughter yoga. Its participants claim that laughing heals all kinds of ailments. It may sound far-fetched, but some scientists think laughter might actually have some measurable health benefits. Then reporter Amanda Aronczyk looked whether laughter can be good medicine for our doctors — especially when they're dealing with taboo things like death and sex. To find out, she spoke to a medical ethicist who teaches improv to doctors and nurses. She discovered that what's funny when doctors joke may depend on who is listening. The instructors and attendees of the Fourth International Medical Improv Train-the-Trainer Workshop hosted by The Northwestern Center for Bioethics & Medical Humanities. (Rachel Jensen) You can listen to Studio 360's episode about the science of laughter here.
One of our first guests on the show last fall was the young poet Max Ritvo. Ritvo, 25, has spent years living with Ewing's Sarcoma, an incurable cancer. Meanwhile he's gotten married, taught at Columbia University, and performed in an improv comedy group. His first book of poetry, Four Reincarnations, comes out this fall. One work from that book, "Poem to My Litter," was just published in the New Yorker. But Ritvo is more than his accomplishments. He's someone who reminded us that there are many different ways to look at death, and dying, and some of them make you actually laugh at loud. He came back to visit us a few weeks ago on what he called his "farewell tour." Even in his final days, Max says he keeps his sense of humor alive. "When you laugh at something horrible, you're just illuminating a different side of it that was already there. If you make something sad funny you're much more likely to remember it. It's a mnemonic device that makes our suffering rhyme with joy." We invited an artist, Nate Milton, to animate two of Max's poems: Poem to My Litter Afternoon
This week we're revisiting an episode from our series on hearing, listening and sound. When Rose* was growing up, she knew something wasn't quite right about how she heard the world. She says it felt like she was isolated by an invisible wall. But when she got typical hearing tests at an audiologist's office? She aced them, every time. Rose's problem was particularly bad in noisy places. "It doesn't take much," she says. "It could be five computers in a room and a bunch of shuffling around — you lose me at that point." It took Rose years, and plenty of doctors' visits, to figure out what was happening. And when she did find out, it was thanks to the persistence of Professor Nina Kraus. Kraus runs an auditory neuroscience laboratory at Northwestern University. For decades, Kraus has been conducting research on Rose and other patients like her to learn just how vital our brains are to understanding sound. And she discovered how hearing difficulties can be a marker for all types of neurological issues — autism, dyslexia, learning delays — that have nothing to do with our ears. *not her real name
The engineer who uncovered the lead crisis in Flint, Michigan – where the water was toxic enough to give kids brain damage – doesn't even live in Michigan. His name is Marc Edwards, and he teaches engineering at Virginia Tech, more than 500 miles away. Marc started investigating water pollution in Flint last August. But he got his start more than a decade ago, in Washington, DC, when he discovered high levels of lead in that city's water. In DC no one would listen to him. He lost lucrative contracts and spent thousands of dollars – of his own money – sampling the water to prove it was contaminated even when the government insisted it was safe. In the end, he prevailed and the water was cleaned up. But not before thousands of kids were exposed to dangerously high amounts of lead. This week, we talk to Edwards about his crusade to make our water safe. Getting the science right turned out to be just the beginning of a fight. The harder part was figuring out how to convince people he was right.
For many sick people, getting even a temporary break from pain sounds too good to be true. But this week we hear from three people who did get a reprieve from a chronic disease, sometimes in very unconventional ways. One of our listeners, Allison, struggled with severe, undiagnosed depression in her twenties. She hooked up with a no-good boyfriend who got her into a dangerous habit: heroin. Today, she's 57 and she knows the guy and the drugs were trouble. But she also says heroin had a surprising side effect. Sara Benincasa is a stand-up comedian who grapples with agoraphobia, a fear of crowds and busy places. But during a trip to the Netherlands she encountered a place that changed how she faces this fear, and helped her see what life could look like when she wasn't scared to leave the house. Hanna wrote into us with a really intimate story about life with ulcerative colitis, an incurable disease with some difficult side effects. When traditional treatments failed, she and her mom tried an experiment that changed how Hanna thinks about her body and her daily life.
One Doctor's Mission: Make Abortion Safe in the South (Rebroadcast)
As the Supreme Court nears its decision on a major abortion case this month, we're revisiting an episode from earlier this year: Willie Parker grew up in Alabama without electricity, one of six kids in a single-mother household. He learned to read by the light of a kerosene lamp. He was also raised in a fundamentalist Christian community that believed abortion was wrong. Single, unwed mothers had to publicly apologize in church. Today, however, Parker is a obstetrician gynecologist who specializes in providing safe abortions in the Deep South. He travels between states and clinics amid protests and threats, and treats the same demographic of women who might have gone to his church. Parker credits his change of heart to a sermon he heard by Martin Luther King Jr., where he alludes to the biblical story of the Good Samaritan—a man who acts out of kindness for the greater good. "The Good Samaritan asks what will happen to this person if I don't stop to help them," Parker said. Women in this region of the United States have few options, Parker says, if they aren't ready to be mothers. The last abortion clinic in Mississippi was attacked last year, and the state moved to block doctors from being able to admitting patients to hospitals after they received an abortion. Parker says the trend of unsafe, secretive abortions are too dangerous to deny women access to care. "Being born in the South, and being reared in abject poverty... if I couldn't make those women a priority, who will?" he says. That perspective has fueled his work and helped shape his faith. It's also the reason he doesn't shy away from being recorded on film or speaking in public, despite the pressure he gets from the pro-life movements that thrive in the Bible Belt. And while Parker has lost some friends, and severed relationships, he is at peace with his decision. "I believe my work is honorable. I believe it is always appropriate to help people," he says. "And so I've made the conscious decision to practice my craft with the dignity and honor that I think it is due."
One Doctor's Mission: Make Abortion Safe in the South (Rebroadcast)
This is the third and final part of our series with NPR about mental health and generation gaps. Rachel Star Withers has had hallucinations since she was a kid. She sees store mannequins taking off their hats, or ticking clocks that don't exist. She's schizophrenic. And instead of hiding it, she talks about it all the time, in videos she posts on YouTube. In our tell-all, share-all culture, more and more people like Rachel are speaking openly about their mental health and challenging the stigma that comes with their diagnoses. And while Withers has to block some naysayers and internet bullies, she says the videos help create a more compassionate community. "It really made me feel not so alone."