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Posted by Howard Rosenthal, EdD on 11/18/11 - 3:13 PM
Maggie began the session by telling me that she had been diagnosed by three different psychiatrists. The good news was that all three agreed on the diagnosis. The bad news was that each psychiatrist told her she was schizophrenic.

"So, what brings you here today?" I asked.

"Well, I saw something in the newspaper and it said you wrote some books on mental health and teach in the field so I thought you might know something these psychiatrists don't."

(Wow. How refreshing. A client who actually thought that a nonmedical mental health professional such as myself would know more than a bona fide MD psychiatrist. Perhaps this was my lucky day. Maybe I should purchase a lottery ticket or search Google for the nearest horse race track.)

As Maggie began talking my elevated mood and optimism began dropping like a thermometer placed in an overactive refrigerator freezer. In short order I was convinced that the psychiatrists were wrong -- dead wrong. This lady wasn't just schizophrenic. Maggie displayed more hallucinations, delusions, and thought disorders, than ten schizophrenics combined. As I listened I couldn't help thinking that the folks who penned the DSM needed a new category. What? Oh heck, I didn't know, perhaps mega-psychotic or super-schizophrenic or something. Now I realize that doesn't sound nice and isn't very high on the Carkhuff Scales, but at least I was facing reality: something Maggie clearly was not doing.

The session went on for what seemed like eternity. At the end of our meeting I was faced with a dilemma. If I diagnosed Maggie as schizophrenic for the fourth time she would be devastated. I scribbled something on her insurance super bill and scheduled her for another appointment.

I continued to see Maggie weekly for approximately one year. To say that she made monumental progress would be an understatement. I thus terminated her.

About a year later I saw an article about her in the neighborhood newspaper. Maggie was being honored by her college for being the only student in her program to snare a perfect 4.0 straight A average as a chemistry major. The article also boasted that she landed a pristine job in her chosen field.

Just days after I read the article Maggie dropped in not for a therapy session (because she was doing very well), but just to say "hello."

"You are doing fantastic," I said. "Listen, I just have to know. What I'm about to ask you will help me with all the clients I will be seeing in the future. Why do you think you made such good progress in therapy? Was it because we explored the abuse in your childhood? Was it the relaxation techniques? Perhaps it was the dream work. Maybe it was the focus on your self-talk."

"Oh no," she replied. "I'm sure those things were helpful, but none of them cured me. No, not a single one of them. I can tell you precisely what it was.

Do you remember when you saw me for the first time and I mentioned that three psychiatrists had diagnosed me as schizophrenic? Well we decided right then and there that because you had written some books and taught in a college you knew a lot more than those psychiatrists. And when I left your office after my first session I felt terrific because I glanced at the insurance bill you gave me and you said I was an undifferentiated type. And that was wonderful news because schizophrenia is caused by chemical imbalances and genetics and it can't be cured. You know that.

But, I wasn't schizophrenic. I was just a normal person who was an undifferentiated type. And that meant I could be cured."

Thus, if you happen to be an advisor in a graduate program and an upbeat perky chemistry major named Maggie comes strolling in, please, pretty please with sugar on top, promise me you won't even think about letting her enroll in an abnormal psychology class.


Filed under: The Art of Psychotherapy, A Day in the Life of a Therapist
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